מילות מפתח: COPD, הענות לטיפול, משאפים

רקע מדעי ומטרה:

Good medication adherence is associated with better disease control and reduced rate of exacerbations and hospitalization.

שיטות:

To assess adherence rates of COPD patients to various inhalers by medication type and route of administration.

תוצאות:

All Clalit members aged 40-80 with a documented diagnosis of COPD before January 1, 2017, were included. Only patients who filled at least one prescription per year in the three consecutive years 2017-2019 for at least one of the study inhalers were included. We analyzed all monthly prescriptions filled between January 1, 2018, and December 31, 2018, and calculated the adherence rate for each inhaler.

מסקנות:

20,413 COPD patients were included in the study. The average age was 68.4±7.1 years; 57.8% were men, and 87.2% of the patients were smokers.
11,323 (55.5%) of the patients were treated with at least one of the study inhalers. The adherence rate varied between 33.9% for Symbicort turbohaler and 80.0% for Onbrez breezhaler. Good Adherence rates were higher for LAMA inhalers 71.9% compared to LABA inhalers 55.3% or steroids inhalers 55.2% (P<0.0001).
The inhaler device was related to the adherent. The lowest odd for good adherence was related to the use of turbohaler or discus devices. Handihaler, breezhaler, aerolizer and elipta devices were related to highest odd for good adherence.

חשיבות לרפואת המשפחה:

Adherence rates in COPD patients were better for LAMA than for LABA and steroids. Moreover, adherence rates were different with different inhaler devices.
Adjustment of the precise medication and inhaler device can improve adherence in COPD patients.