title: Adherence and persistence with fluticasone propionate/salmeterol combination therapy.
abstract: BACKGROUND
  Pharmacy database medication refill studies provide a panoramic view of medication-taking behavior in patients nationally.
  
  
  OBJECTIVE
  To investigate fluticasone propionate/salmeterol combination (FSC) adherence, including the factors associated with refill adherence in a large national pharmacy database.
  
  
  METHODS
  Adherence and persistence were documented for 12 months from date of initial FSC prescription in 5504 patients who filled their medication at a nationwide pharmacy chain.
  
  
  RESULTS
  On average, patients filled enough medication to cover 22.2% of days. More than half the patients filled a 30-day prescription only once over the 1-year interval. Higher adherence levels were associated with being male, being older than 35 years, having a comorbid disorder, a having a copay of 1.01 dollar to 10 dollars, previous beta2-agonist use, and a prescription for higher-dose FSC.
  
  
  CONCLUSIONS
  This pharmacy database study portrays medication adherence levels to be considerably lower than those reported in most clinical trials, suggests that most adults taking FSC obtain a single fill before abandoning their controller medication, and indicates a need for a reappraisal of current treatment guidelines and educational strategies for both providers and patients.
  
  
  CONCLUSIONS
  For many patients, filling of a controller medication is markedly discrepant with practice guidelines. Reappraisal of both the guidelines and strategies to implement them is in order.
authors.affiliation: Department of Pediatrics, National Jewish Medical and Research Center, Denver, CO 80206, USA. benderb@njc.org
authors.forename: Bruce G
authors.initials: BG
authors.lastname: Bender
authors.forename: Alex
authors.initials: A
authors.lastname: Pedan
authors.forename: Laleh T
authors.initials: LT
authors.lastname: Varasteh
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000420:Albuterol / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000730:Androstadienes / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy*; D001993:Bronchodilator Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004359:Drug Therapy, Combination; D005260:Female; D000068298:Fluticasone; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000706:statistics & numerical data*; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy*; D012189:Retrospective Studies; D000068299:Salmeterol Xinafoate; D012737:Sex Factors
chemical_list: D000730:Androstadienes; D001993:Bronchodilator Agents; D000068299:Salmeterol Xinafoate; D000068298:Fluticasone; D000420:Albuterol