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Krack, G. ; Kirsch, F. ; Schwarzkopf, L. ; Schramm, A.* ; Leidl, R.

Can adherence to and persistence with inhaled long-acting bronchodilators improve the quality of life in patients with chronic obstructive pulmonary disease? Results from a German disease management program.

Clin. Drug Invest. 41, 989–998 (2021)
DOI PMC
Open Access Green möglich sobald Postprint bei der ZB eingereicht worden ist.
Background and Objective: Adherence to and persistence with inhaled long-acting bronchodilators (ILAB), is commonly considered to be a relevant driver of perceived health-related quality of life (HRQoL) in chronic obstructive pulmonary disease (COPD), but the topic is rarely studied with real-world data. Using survey and health insurance claims data, this study investigates the effect of adherence to and persistence with ILAB on EQ-5D-5L visual analog scale (VAS) in ILAB users who were enrolled in the German disease management programs (DMP) for COPD. Methods: Included ILAB users were aged ≥ 18 years, continuously insured with AOK Bavaria and enrolled in the DMP for COPD. Adherence to ILAB [proportion of days covered (PDC); PDC ≥ 80%], and persistence (days of uninterrupted ILAB therapy) were assessed in the year preceding the study’s HRQoL questionnaire. In a cross-sectional design we applied quasi-Poisson models with log link function and subgroup analyses. The robustness of results was analyzed with comprehensive sensitivity analyses. Results: Patients with PDC ≥ 80% had 2.96% higher VAS scores than patients with lower PDCs. From all analyses, patients with GOLD stage III had the highest effects from PDC ≥ 80% (5.33% increased VAS). Patients without heart failure profited significantly more from PDC ≥ 80% (+ 4.34% vs − 2.88%) and from an additional persistent day (+ 0.01% vs – 0.01%) than patients with heart failure. Conclusions: Overall, ILAB users significantly profited from PDC ≥ 80%, but not from continuous PDC or persistent days. In secondary subgroup analyses, patients with GOLD stage III and patients without heart failure particularly profited from PDC ≥ 80%. Only patients without heart failure particularly profited from more persistent days. Because identified effects were small and often not robust, advancing adherence and persistence alone may not improve the German DMP for COPD substantially.
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Publikationstyp Artikel: Journalartikel
Dokumenttyp Wissenschaftlicher Artikel
Schlagwörter Medication Adherence; Copd; Therapy; Impact; Values
ISSN (print) / ISBN 1173-2563
e-ISSN 1179-1918
Zeitschrift Clinical Drug Investigation
Quellenangaben Band: 41, Heft: , Seiten: 989–998 Artikelnummer: , Supplement: ,
Verlag Springer
Verlagsort 5 The Warehouse Way, Northcote 0627, Auckland, New Zealand
Begutachtungsstatus Peer reviewed
Institut(e) Institute of Health Economics and Health Care Management (IGM)
Förderungen Federal Joint Committee (G-BA), Innovation Fund