PMID- 28760010
OWN - NLM
STAT- MEDLINE
DCOM- 20180129
LR  - 20181202
IS  - 1542-6270 (Electronic)
IS  - 1060-0280 (Linking)
VI  - 51
IP  - 12
DP  - 2017 Dec
TI  - Adherence and Persistence to Long-Acting Anticholinergics Treatment Episodes in 
      Patients With Chronic Obstructive Pulmonary Disease.
PG  - 1063-1068
LID - 10.1177/1060028017723349 [doi]
AB  - BACKGROUND: No studies have examined adherence or persistence to long-acting 
      anticholinergics (LAAC) treatment episodes in patients with chronic obstructive 
      pulmonary disease (COPD). OBJECTIVE: To estimate 1-year adherence and 5-year 
      persistence to LAAC during treatment episodes, and the likelihood of initiating a 
      subsequent treatment episode. METHODS: A retrospective cohort of LAAC-treated 
      COPD patients was reconstructed from Quebec databases. A treatment episode was 
      initiated at cohort entry, defined as the first LAAC prescription date on/after 
      the first COPD diagnosis date recorded between October 1, 2003, and March 31, 
      2014. We identified a subsequent treatment episode up to 5 years after the end of 
      the episode initiated at cohort entry. We measured adherence as the proportion of 
      days covered over 1 year. Persistence was defined as prescription renewal within 
      90 days of the previous prescription and was plotted using Kaplan-Meier curves 
      over 5 years. The 5-year hazard and cumulative incidence of initiating a 
      subsequent episode were estimated with survival analyses. We compared adherence 
      and persistence between the treatment episodes using t and log-rank tests. 
      RESULTS: The cohort included 113 435 COPD patients. Adherence and persistence to 
      LAAC were significantly lower in the subsequent treatment episode (55% vs 63%; P 
      < 0.0001). The likelihood of initiating a subsequent episode was greatest 
      immediately after the cessation of the initial episode, with 59% of patients 
      starting a subsequent episode within 1 year. CONCLUSION: Adherence and 
      persistence to LAAC were lower in the subsequent treatment episode. Interventions 
      should be offered quickly after LAAC cessation.
FAU - Savaria, Francois
AU  - Savaria F
AD  - 1 Universite de Montreal, Montreal, Quebec, Canada.
FAU - Beauchesne, Marie-France
AU  - Beauchesne MF
AD  - 1 Universite de Montreal, Montreal, Quebec, Canada.
AD  - 2 Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Quebec, Canada.
AD  - 3 Endowment Pharmaceutical Chair AstraZeneca in Respiratory Health, Montreal, 
      Quebec, Canada.
FAU - Forget, Amelie
AU  - Forget A
AD  - 1 Universite de Montreal, Montreal, Quebec, Canada.
AD  - 4 Hopital du Sacre-Coeur de Montreal, Montreal, Quebec, Canada.
FAU - Blais, Lucie
AU  - Blais L
AD  - 1 Universite de Montreal, Montreal, Quebec, Canada.
AD  - 3 Endowment Pharmaceutical Chair AstraZeneca in Respiratory Health, Montreal, 
      Quebec, Canada.
AD  - 4 Hopital du Sacre-Coeur de Montreal, Montreal, Quebec, Canada.
LA  - eng
PT  - Journal Article
DEP - 20170731
PL  - United States
TA  - Ann Pharmacother
JT  - The Annals of pharmacotherapy
JID - 9203131
RN  - 0 (Bronchodilator Agents)
RN  - 0 (Cholinergic Antagonists)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Bronchodilator Agents/*therapeutic use
MH  - Cholinergic Antagonists/*therapeutic use
MH  - Databases, Factual
MH  - Female
MH  - Humans
MH  - Male
MH  - Medication Adherence/*statistics & numerical data
MH  - Middle Aged
MH  - Pulmonary Disease, Chronic Obstructive/*drug therapy
MH  - Quebec
MH  - Retrospective Studies
MH  - Time Factors
OTO - NOTNLM
OT  - adherence
OT  - administrative databases
OT  - chronic obstructive pulmonary disease
OT  - long-acting anticholinergics
OT  - persistence
OT  - treatment episode
EDAT- 2017/08/02 06:00
MHDA- 2018/01/30 06:00
CRDT- 2017/08/02 06:00
PHST- 2017/08/02 06:00 [pubmed]
PHST- 2018/01/30 06:00 [medline]
PHST- 2017/08/02 06:00 [entrez]
AID - 10.1177/1060028017723349 [doi]
PST - ppublish
SO  - Ann Pharmacother. 2017 Dec;51(12):1063-1068. doi: 10.1177/1060028017723349. Epub 
      2017 Jul 31.