What Affects Prescription Adherence of Patients With Obstructive Lung Disease?

Prescription nonadherence patterns among adult patients with obstructive lung disease (OLD) demonstrate that medical complexity increases the risk for noncompliance. A first-of-its kind retrospective analysis of electronic medical record (EMR) and administrative data, which examined primary prescription adherence with OLD medications, was conducted. Results of the study were published in the journal Allergy, Asthma & Clinical Immunology.

The researchers sought to establish primary prescription adherence — defined as dispensation of a new prescription within 90 days of the date that the prescription was written — for OLD in an adult primary care patient population over 3 years. The current analysis was performed using data from the Manitoba Primary Care Research Network, which is a repository of de-identified primary care EMR data. This network comprises 44 primary care clinics in Manitoba, Canada.

Prescriptions that were written between April 1, 2012, and December 31, 2015, were linked to Manitoba’s Drug Program Information Network data for medications classified as being used for obstructive airway diseases, which includes asthma and chronic obstructive pulmonary disease (COPD).

The study outcome was primary adherence. Hospitalization or death within 90 days of the prescription date constituted exclusion criteria.

Overall, 61.4% of the participants were women. With respect to age-groups, 37.6% of the participants were 18 to 44 years old and 38.2% were 45 to 64 years old. A total of 13,220 prescriptions that were classified as drugs for OLD were written, of which 75.9% were filled within 90 days.

Per multivariate analysis, depression was associated with a decreased likelihood of prescription adherence (odds ratio [OR], 0.87; 95% CI, 0.76 to 0.98). Certain age-groups were also linked to decreased odds of prescription adherence (18 to 44 years: OR, 0.84; 95% CI, 0.72 to 0.98 and 65 to 74 years: OR, 0.83; 95% CI, 0.70 to 0.98).

Income quintile impacted the likelihood of prescription adherence, with increased odds of filling prescriptions reported among lower income quintiles.

The odds of prescription adherence were associated with 3 or more emergency department (ED) visits in the prior year compared with no ED visits (OR, 1.36; 95% CI, 1.01 to 1.84), 6 or more prescriptions filled in the previous year compared with 0 to 2 prescriptions filled (OR, 1.22; 95% CI, 1.07 to 1.38), and more comorbidities.

The odds of prescription adherence did not increase due to the number of ambulatory visits or hospitalizations in the previous year, nor did 1 or 2 ED visits in the prior year vs no ED visits increase the odds.

The investigators concluded that the current study provides key insights into factors linked to prescription nonadherence.

Disclosure: One of the study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures. 

Reference

Singer AG, Katz A, LaBine L, et al. Primary prescription adherence for obstructive lung disease in a primary care population. Allergy Asthma Clin Immunol. 2021;17(1):57. doi:10.1186/s13223-021-00540-7