Health care education, delivery, and qualityPatients with asthma who do not fill their inhaled corticosteroids: A study of primary nonadherence
Section snippets
Study population and setting
This study was approved by the Institutional Review Board at Henry Ford Health System and was in compliance with its Health Insurance Portability and Accountability Act policy. Patients were members of a large health maintenance organization in southeast Michigan and received their care from a large, multispecialty medical group. To be included in the analytic set, patients had to meet the following eligibility criteria: age 5 to 56 years; at least 1 electronic prescription for an ICS between
Results
We identified 1064 patients with asthma who met the inclusion and exclusion criteria (Fig 1). The time difference between receipt of the index ICS prescription and filling of that prescription is shown in Table I. Most patients (90%) filled their prescription within 3 months of receipt, primarily in the first week (83%). However, approximately 3% of patients eventually filled their prescription after a lag time exceeding 3 months and 8% never filled their ICS prescription during follow-up (ie,
Discussion
This is the largest study to examine primary nonadherence to ICSs and is unique in its use of electronic prescription data paired with pharmacy fill data. The latter allowed us to track many more asthma medication prescriptions than previously.4, 5 Our study findings show that the rate of primary nonadherence (ie, never filling) to inhaled corticosteroids was 8%. Even using various criteria for primary nonadherence, our rates of nonfilling were much lower than the value of 30% reported
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Supported by a grant from the National Heart Lung and Blood Institute, National Institutes of Health (R01HL079055), and the Fund for Henry Ford Hospital.
Disclosure of potential conflict of interest: L. K. Williams has received grant support from the National Institute of Allergy and Infectious Diseases and the National Heart, Lung, and Blood Institute, National Institutes of Health. The rest of the authors have declared that they have no conflict of interest.