Impact of multiple-dose versus single-dose inhaler devices on COPD patients' persistence with long-acting β₂-agonists: a dispensing database analysis

Job F M van Boven; Joost J van Raaij; Ruben van der Galiën; Maarten J Postma; Thys van der Molen; P N Richard Dekhuijzen; Stefan Vegter

doi:10.1038/npjpcrm.2014.69

Impact of multiple-dose versus single-dose inhaler devices on COPD patients' persistence with long-acting β₂-agonists: a dispensing database analysis

Job F M van Boven^*, Joost J van Raaij, Ruben van der Galiën, Maarten J Postma, Thys van der Molen, P N Richard Dekhuijzen, Stefan Vegter

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

BACKGROUND: With a growing availability of different devices and types of medication, additional evidence is required to assist clinicians in prescribing the optimal medication in relation to chronic obstructive pulmonary disease (COPD) patients' persistence with long-acting β2-agonists (LABAs).

AIMS: To assess the impact of the type of inhaler device (multiple-dose versus single-dose inhalers) on 1-year persistence and switching patterns with LABAs.

METHODS: A retrospective observational cohort study was performed comparing a cohort of patients initiating multiple-dose inhalers and a cohort initiating single-dose inhalers. The study population consisted of long-acting bronchodilator naive COPD patients, initiating inhalation therapy with mono-LABAs (formoterol, indacaterol or salmeterol). Analyses were performed using pharmacy dispensing data from 1994 to 2012, obtained from the IADB.nl database. Study outcomes were 1-year persistence and switching patterns. RESULTS were adjusted for initial prescriber, initial medication, dosing regimen and relevant comorbidities.

RESULTS: In all, 575 patients initiating LABAs were included in the final study cohort. Among them, 475 (83%) initiated a multiple-dose inhaler and 100 (17%) a single-dose inhaler. Further, 269 (47%) initiated formoterol, 9 (2%) indacaterol and 297 (52%) salmeterol. There was no significant difference in persistence between users of multiple-dose or single-dose inhalers (hazard ratio: 0.98, 95% confidence interval: 0.76-1.26, P=0.99). Over 80% re-started or switched medication.

CONCLUSIONS: There seems no impact of inhaler device (multiple-dose versus single-dose inhalers) on COPD patients' persistence with LABAs. Over 80% of patients who initially seemed to discontinue LABAs, re-started their initial medication or switched inhalers or medication within 1 year.

Original language	English
Pages (from-to)	14069
Journal	npj Primary Care Respiratory Medicine
Volume	24
DOIs	https://doi.org/10.1038/npjpcrm.2014.69
Publication status	Published - 2 Oct 2014
Externally published	Yes

Keywords

Adrenergic beta-2 Receptor Agonists/administration & dosage
Aged
Albuterol/administration & dosage
Cohort Studies
Databases, Factual
Ethanolamines/administration & dosage
Female
Formoterol Fumarate
Humans
Indans/administration & dosage
Male
Metered Dose Inhalers
Pulmonary Disease, Chronic Obstructive/drug therapy
Quinolones/administration & dosage
Retrospective Studies
Salmeterol Xinafoate

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van Boven, J. F. M., van Raaij, J. J., van der Galiën, R., Postma, M. J., van der Molen, T., Dekhuijzen, P. N. R., & Vegter, S. (2014). Impact of multiple-dose versus single-dose inhaler devices on COPD patients' persistence with long-acting β₂-agonists: a dispensing database analysis. npj Primary Care Respiratory Medicine, 24, 14069. https://doi.org/10.1038/npjpcrm.2014.69

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abstract = "BACKGROUND: With a growing availability of different devices and types of medication, additional evidence is required to assist clinicians in prescribing the optimal medication in relation to chronic obstructive pulmonary disease (COPD) patients' persistence with long-acting β2-agonists (LABAs).AIMS: To assess the impact of the type of inhaler device (multiple-dose versus single-dose inhalers) on 1-year persistence and switching patterns with LABAs.METHODS: A retrospective observational cohort study was performed comparing a cohort of patients initiating multiple-dose inhalers and a cohort initiating single-dose inhalers. The study population consisted of long-acting bronchodilator naive COPD patients, initiating inhalation therapy with mono-LABAs (formoterol, indacaterol or salmeterol). Analyses were performed using pharmacy dispensing data from 1994 to 2012, obtained from the IADB.nl database. Study outcomes were 1-year persistence and switching patterns. RESULTS were adjusted for initial prescriber, initial medication, dosing regimen and relevant comorbidities.RESULTS: In all, 575 patients initiating LABAs were included in the final study cohort. Among them, 475 (83%) initiated a multiple-dose inhaler and 100 (17%) a single-dose inhaler. Further, 269 (47%) initiated formoterol, 9 (2%) indacaterol and 297 (52%) salmeterol. There was no significant difference in persistence between users of multiple-dose or single-dose inhalers (hazard ratio: 0.98, 95% confidence interval: 0.76-1.26, P=0.99). Over 80% re-started or switched medication.CONCLUSIONS: There seems no impact of inhaler device (multiple-dose versus single-dose inhalers) on COPD patients' persistence with LABAs. Over 80% of patients who initially seemed to discontinue LABAs, re-started their initial medication or switched inhalers or medication within 1 year.",

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author = "{van Boven}, {Job F M} and {van Raaij}, {Joost J} and {van der Gali{\"e}n}, Ruben and Postma, {Maarten J} and {van der Molen}, Thys and Dekhuijzen, {P N Richard} and Stefan Vegter",

year = "2014",

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day = "2",

doi = "10.1038/npjpcrm.2014.69",

language = "English",

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pages = "14069",

journal = "npj Primary Care Respiratory Medicine",

issn = "2055-1010",

publisher = "Nature Research",

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Impact of multiple-dose versus single-dose inhaler devices on COPD patients' persistence with long-acting β₂-agonists: a dispensing database analysis. / van Boven, Job F M; van Raaij, Joost J; van der Galiën, Ruben et al.
In: npj Primary Care Respiratory Medicine, Vol. 24, 02.10.2014, p. 14069.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - Impact of multiple-dose versus single-dose inhaler devices on COPD patients' persistence with long-acting β₂-agonists

T2 - a dispensing database analysis

AU - van Boven, Job F M

AU - van Raaij, Joost J

AU - van der Galiën, Ruben

AU - Postma, Maarten J

AU - van der Molen, Thys

AU - Dekhuijzen, P N Richard

AU - Vegter, Stefan

PY - 2014/10/2

Y1 - 2014/10/2

N2 - BACKGROUND: With a growing availability of different devices and types of medication, additional evidence is required to assist clinicians in prescribing the optimal medication in relation to chronic obstructive pulmonary disease (COPD) patients' persistence with long-acting β2-agonists (LABAs).AIMS: To assess the impact of the type of inhaler device (multiple-dose versus single-dose inhalers) on 1-year persistence and switching patterns with LABAs.METHODS: A retrospective observational cohort study was performed comparing a cohort of patients initiating multiple-dose inhalers and a cohort initiating single-dose inhalers. The study population consisted of long-acting bronchodilator naive COPD patients, initiating inhalation therapy with mono-LABAs (formoterol, indacaterol or salmeterol). Analyses were performed using pharmacy dispensing data from 1994 to 2012, obtained from the IADB.nl database. Study outcomes were 1-year persistence and switching patterns. RESULTS were adjusted for initial prescriber, initial medication, dosing regimen and relevant comorbidities.RESULTS: In all, 575 patients initiating LABAs were included in the final study cohort. Among them, 475 (83%) initiated a multiple-dose inhaler and 100 (17%) a single-dose inhaler. Further, 269 (47%) initiated formoterol, 9 (2%) indacaterol and 297 (52%) salmeterol. There was no significant difference in persistence between users of multiple-dose or single-dose inhalers (hazard ratio: 0.98, 95% confidence interval: 0.76-1.26, P=0.99). Over 80% re-started or switched medication.CONCLUSIONS: There seems no impact of inhaler device (multiple-dose versus single-dose inhalers) on COPD patients' persistence with LABAs. Over 80% of patients who initially seemed to discontinue LABAs, re-started their initial medication or switched inhalers or medication within 1 year.

AB - BACKGROUND: With a growing availability of different devices and types of medication, additional evidence is required to assist clinicians in prescribing the optimal medication in relation to chronic obstructive pulmonary disease (COPD) patients' persistence with long-acting β2-agonists (LABAs).AIMS: To assess the impact of the type of inhaler device (multiple-dose versus single-dose inhalers) on 1-year persistence and switching patterns with LABAs.METHODS: A retrospective observational cohort study was performed comparing a cohort of patients initiating multiple-dose inhalers and a cohort initiating single-dose inhalers. The study population consisted of long-acting bronchodilator naive COPD patients, initiating inhalation therapy with mono-LABAs (formoterol, indacaterol or salmeterol). Analyses were performed using pharmacy dispensing data from 1994 to 2012, obtained from the IADB.nl database. Study outcomes were 1-year persistence and switching patterns. RESULTS were adjusted for initial prescriber, initial medication, dosing regimen and relevant comorbidities.RESULTS: In all, 575 patients initiating LABAs were included in the final study cohort. Among them, 475 (83%) initiated a multiple-dose inhaler and 100 (17%) a single-dose inhaler. Further, 269 (47%) initiated formoterol, 9 (2%) indacaterol and 297 (52%) salmeterol. There was no significant difference in persistence between users of multiple-dose or single-dose inhalers (hazard ratio: 0.98, 95% confidence interval: 0.76-1.26, P=0.99). Over 80% re-started or switched medication.CONCLUSIONS: There seems no impact of inhaler device (multiple-dose versus single-dose inhalers) on COPD patients' persistence with LABAs. Over 80% of patients who initially seemed to discontinue LABAs, re-started their initial medication or switched inhalers or medication within 1 year.

KW - Adrenergic beta-2 Receptor Agonists/administration & dosage

KW - Aged

KW - Albuterol/administration & dosage

KW - Cohort Studies

KW - Databases, Factual

KW - Ethanolamines/administration & dosage

KW - Female

KW - Formoterol Fumarate

KW - Humans

KW - Indans/administration & dosage

KW - Male

KW - Metered Dose Inhalers

KW - Pulmonary Disease, Chronic Obstructive/drug therapy

KW - Quinolones/administration & dosage

KW - Retrospective Studies

KW - Salmeterol Xinafoate

U2 - 10.1038/npjpcrm.2014.69

DO - 10.1038/npjpcrm.2014.69

M3 - Article

C2 - 25274453

SN - 2055-1010

VL - 24

SP - 14069

JO - npj Primary Care Respiratory Medicine

JF - npj Primary Care Respiratory Medicine

ER -

Impact of multiple-dose versus single-dose inhaler devices on COPD patients' persistence with long-acting β₂-agonists: a dispensing database analysis

Abstract

Keywords

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