Are patients with COPD more adherent to single-inhaler compared with multiple-inhaler triple therapy in a real-world UK primary care treated population?

Abstract

<b>Background:</b> Triple therapy (ICS/LAMA/LABA) is recommended for COPD patients who continue to experience exacerbations or symptoms on dual therapy (LAMA/LABA or ICS/LABA). Adherence to multiple inhaler triple therapy (MITT) is known to be poor. <b>Aim:</b> To investigate the real-world comparative adherence to single inhaler triple therapy (SITT) vs MITT in UK COPD patients. <b>Methods:</b> This retrospective analysis of linked UK primary and secondary care data (CPRD [Clinical Practice Research Datalink] Aurum; HES [Hospital Episode Statistics]) indexed patients on the first prescription of SITT or MITT between Nov 2017–June 2019. Inclusion criteria were age≥35 years, COPD diagnosis, FEV1/FVC &lt;0.7, linkage to HES and continuous GP registration for 12 months pre- and 6 months post-index. Inverse probability of treatment weighting was used to balance 15 baseline characteristics. Adherence was measured using proportion of days covered (PDC) by days’ supply of SITT or MITT prescriptions. Proportions of adherent patients (PDC≥0.80) were evaluated. <b>Results:</b> Of the 4080 SITT and 6579 MITT users meeting study criteria, SITT users had significantly higher adherence at 6, 12 and 18 months than MITT users; p&lt;0.001 for all comparisons. Figure 1. <b>Conclusion:</b> In the UK, patients with COPD initiating SITT have significantly better adherence compared with patients initiating MITT. <b>GSK Funding:</b> Study 208114