ArticleInternational journal of chronic obstructive pulmonary disease2018
Association between poor therapy adherence to inhaled corticosteroids and tiotropium and morbidity and mortality in patients with COPD.
Article in International journal of chronic obstructive pulmonary disease, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 3 of them syntheses that pooled it.
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Who cites it
11 citing papers in PubMed, 3 syntheses or guidelines pooled it, 28 citations in OpenAlex.
- Medication adherence to inhalation therapy and the risk of COPD exacerbations: a systematic review with meta-analysis.BMJ open respiratory research · 2024Pooled it
- Adherence-enhancing interventions for pharmacological and oxygen therapy in patients with COPD: a systematic review and component network meta-analyses.European respiratory review : an official journal of the European Respiratory Society · 2024Pooled it
- Methods to assess COPD medications adherence in healthcare databases: a systematic review.European respiratory review : an official journal of the European Respiratory Society · 2023Pooled it
- Development and validation of a nomogram model for mortality prediction in stable chronic obstructive pulmonary disease patients: A prospective observational study in the RealDTC cohort.Journal of global health · 2024Observational
- Adherence enhancing interventions for pharmacological and oxygen therapy in patients with COPD: protocol for a systematic review and component network meta-analyses.Systematic reviews · 2023Article
- Correlation Analysis of the Therapy Adherence to Long-Acting Inhalers Among Patients with Stable COPD.Patient preference and adherence · 2023Article
- Complex Evaluation of Surfactant Protein A and D as Biomarkers for the Severity of COPD.International journal of chronic obstructive pulmonary disease · 2022Article
- Evidence of the association between adherence to treatment and mortality among patients with COPD monitored at a public disease management program in Brazil.Jornal brasileiro de pneumologia : publicacao oficial da Sociedade Brasileira de Pneumologia e Tisilogia · 2021Article
- Inhaler Technique and Self-reported Adherence to Medications Among Hospitalised People with Asthma and COPD.Drugs - real world outcomes · 2020Article
- Predictors of Low-Level Disease-Specific Knowledge in Patients with Chronic Obstructive Pulmonary Disease.International journal of chronic obstructive pulmonary disease · 2020Article
- Adherence to Inhaled Therapy in Patients with COPD Associated to Pneumoconiosis.International journal of chronic obstructive pulmonary diseaseArticle
Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Aim: The aim of this study was to analyze the association between therapy adherence to inhaled corticosteroids (ICSs) and tiotropium on the one hand and morbidity and mortality in COPD on the other hand. Methods: Therapy adherence to ICSs and tiotropium over a 3-year period of, respectively, 635 and 505 patients was collected from pharmacy records. It was expressed as percentage and deemed optimal at ≥75-≤125%, suboptimal at ≥50%-<75%, and poor at <50% (underuse) or >125% (overuse). The association between adherence and time to first hospital admission for an acute exacerbation of chronic obstructive pulmonary disease (AECOPD), community acquired pneumonia (CAP), and mortality was analyzed, with optimal use as the reference category. Results: Suboptimal use and underuse of ICSs and tiotropium were associated with a substantial increase in mortality risk: hazard ratio (HR) of ICSs was 2.9 (95% CI 1.7-5.1) and 5.3 (95% CI 3.3-8.5) and HR of tiotropium was 3.9 (95% CI 2.1-7.5) and 6.4 (95% CI 3.8-10.8) for suboptimal use and underuse, respectively. Suboptimal use and overuse of tiotropium were also associated with an increased risk of CAP, HR 2.2 (95% CI 1.2-4.0) and HR 2.3 (95% CI 1.2-4.7), respectively. Nonadherence to tiotropium was also associated with an increased risk of severe AECOPD: suboptimal use HR 3.0 (95% CI 2.01-4.5), underuse HR 1.9 (95% CI 1.2-3.1), and overuse HR 1.84 (95% CI 1.1-3.1). Nonadherence to ICSs was not related to time to first AECOPD or first CAP. Conclusion: Poor adherence to ICSs and tiotropium was associated with a higher mortality risk. Furthermore, nonadherence to tiotropium was associated with a higher morbidity. The question remains whether improving adherence can reduce morbidity and mortality.
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