Adherence to asthma controller medication regimens

Background: Improved adherence to inhaled corticosteroids (ICS) is recognized as an important factor in reduced morbidity, mortality and consumption of health care resources. The present study was designed to replicate pervious reports of patient adherence with fluticasone/satmeterol in a single inhaler (FSC), fluticasone and salmeterol. in separate inhalers (FP+SAL), fluticasone and montetukast (FP+MON), fluticasone alone (FP) and montelukast atone (MON). Methods: A 24-month observational retrospective study was conducted using administrative claims data. Subjects were >= 2 years old with 24 months of continuous enrollment; had >= 1 asthma claim (ICD-9: 493), >= 1 short-acting beta(2)-agonist claim, and >= 1 FSC, FP, SAL, or MON claim. Outcomes included asthma medication refill rates and persistence measured by treatment days. This study was designed with a unique population of patients with asthma from different health plans to validate previous findings. Results: A total of 3503 subjects were identified based on their index medication: FSC (996), FP+SAL(259), FP+MON(101), FP(1254) and MON(893). Mean number of prescription refills for FSC(3.98) was significantly higher than FP(2.29) and the FP component of FP+SAL(2.36), and FP+MON(2.15), P<0.05. No significant differences were observed between FSC and MON fill rates (4.33). Mean number of treatment days was greater for FSC compared to FP, FP+SAL, and FP+MON (P<0.0001). Conclusion: This study confirms a previous report that adherence profiles of fluticasone and salmeterol in a single inhaler are significantly better when compared to the controller regimens of fluticasone and salmeterol in separate inhalers, fluticasone and montelukast, or fluticasone atone and similar to montelukast alone. (c) 2005 Elsevier Ltd. All rights reserved.