Noncompliance with Drug Therapy for Chronic Obstructive Pulmonary Disease: A Risk Factor for Hospitalization?

Abstract

Objectives To determine if patients who were noncompliant with prescribed medications for chronic obstructive pulmonary disease (COPD) had higher rates of hospitalization. Methods A retrospective case-control study was performed in a tertiary-care university-affiliated Veterans Administration Health Care System setting. Subjects included 93 patients hospitalized for exacerbation of COPD and 93 controls with a diagnosis of COPD who did not require hospitalization. Utilizing pharmacy prescription fill records, medication noncompliance rates of patients who required hospitalization for exacerbation of COPD were compared with patients who did not require such hospitalization. Results The mean noncompliance ratio for the hospitalized patients was lower than the ratio for the controls (0.19 vs. 0.20) although the difference was not statistically significant (P = .95). There was no statistically significant difference between the demographics of the two groups. However, the patients who were hospitalized had a significantly greater number of COPD and nonCOPD medications ( P < .0001, P < .0001) prescribed. They also had significantly more nonCOPD admissions and lengths of stay (P = .02, P = .01). Conclusions At the levels of medication noncompliance observed in this population, there was no difference in rates of hospitalization. Hospitalization could be attributed to other causes such as severity of illness and existence of other comorbid conditions. The effects of environmental pollution and cigarette smoking were not studied.