Abstract
The aim of this observational, retrospective study was to describe characteristics, treatment patterns, and adherence among patients with asthma who initiated multiple-inhaler triple therapy (MITT) in Catalonia, Spain. This study used data of patients initiating MITT in 2016 from the SIDIAP (Information System for Research in Primary Care) database, which covers ~80% of the Catalonian population (5.8 million). Of 1,204 patients initiating MITT, 361 (30.0%) stepped down (discontinued ≥ 1 and continued ≥1 MITT component) and 89 (7.4%) stopped all three components of MITT for a period of 60 days during the following 12 months. In the follow-up period, 196 (16.3%) patients were considered adherent to MITT (>0.8 proportion of days covered [PDC]), with a mean (standard deviation) PDC of 0.52 (0.51) days. Given the low adherence and substantial rates of step down/discontinuation among patients initiating MITT, there is an urgent need to implement strategies to improve treatment adherence/persistence.
Highlights
Asthma is a heterogeneous chronic inflammatory respiratory disease that is often both over- and underdiagnosed[1–3]
Of 1,204 patients included in this study, 851 (70.7%) were female and the mean age at multiple-inhaler triple therapy (MITT) initiation was 54.8 (13.8) years (Table 1)
Body mass index (BMI), smoking status, and percentage of eosinophils measured in peripheral blood were comparable pre- and post-index (Table 1)
Summary
Asthma is a heterogeneous chronic inflammatory respiratory disease that is often both over- and underdiagnosed[1–3]. 1990 to 2015, the prevalence of asthma increased by 12.6%. Between 30 and 50% of patients with moderate/severe asthma have inadequately controlled disease despite attempts to optimize adherence to inhaled corticosteroids in combination with a long-acting β2-agonist (ICS/LABA)[8–12]. Cross-sectional study conducted in Spain, the prevalence of uncontrolled severe persistent asthma among patients with asthma seen at pneumology and allergology hospital units based on a physician’s diagnosis was 3.9% (N = 36,649). The most common treatments recommended for both moderate/severe asthma and uncontrolled severe persistent asthma are ICS/LABA alone or in combination with a short-acting β2-agonist (SABA) or a leukotriene receptor antagonist[13]. The Global Initiative for Asthma (GINA) recommends adding long-acting muscarinic antagonists (LAMA) as an additional controller for patients with uncontrolled asthma on at least medium-dose ICS/LABA therapy[2]
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