title: Adherence to anti-inflammatory treatment for asthma in clinical practice in France.
abstract: OBJECTIVE
  This study evaluated adherence to anti-inflammatory controller medication for asthma in a French population.
  
  
  METHODS
  This was an observational cohort study that employed data from the health insurance database for the Aquitaine region of France. Eligible subjects were aged between 15 and 45 years and had > or = 1 reimbursement claim for anti-inflammatory controller medication between December 1, 2003, and December 31, 2003. Data were collected from June 1, 2003, to May 28, 2005. New users were defined as those having no reimbursement claim for any asthma controller medication in the 6 months preceding the index date; all others were considered previous users. All subjects were followed for 17 months. Continuous multiple-interval measures of medication availability and medication gaps, treatment persistence, and time to first renewal were calculated for users of inhaled corticosteroids (ICS) alone, users of ICS combined with a long-acting beta2-agonist (LABA) in a single inhaler (ICS/LABA) or in separate inhalers (ICS + LABA), and users of oral leukotriene antagonists.
  
  
  RESULTS
  The study population contained 12,502 new and previous users of anti-inflammatory controller medication for asthma. Their mean (SD) age was 32.0 (8.9) years and 58.3% were female. Previous users had better adherence to treatment than new users with respect to all measures. Adherence was best in previous users of leukotriene antagonists. However, only 40.2% of previous users of leukotriene antagonists had sufficient medication (95% CI, 37.6-42.9), compared with 56.8% of previous users of ICS + LABA (95% CI, 50.7-62.8), 65.5% of previous users of ICS only (95% CI, 63.1-67.9), and 69.8% of previous users of ICS/LABA (95% CI, 68.2-71.4). The rate of persistence over a 1-year period was 44.3% for previous users of leukotriene antagonists (95% CI, 41.7-46.8), compared with 27.1% for previous users of ICS only (95% CI, 25.1-29.1), 32.1% for previous users of ICS/LABA (95% CI, 30.5-33.6), and 44.1% for previous users of ICS + LABA (95% CI, 38.2-50.0).
  
  
  CONCLUSIONS
  Adherence to treatment was poor (< or = 44%) in these users of anti-inflammatory controller medications for asthma.
authors.affiliation: Echelon régional du service médical de l'assurance maladie d'Aquitaine, Bordeaux, France; Inserm U 657, Bordeaux, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Latry
authors.forename: Marion
authors.initials: M
authors.lastname: Pinet
authors.forename: Anne
authors.initials: A
authors.lastname: Labat
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Magand
authors.forename: Claude
authors.initials: C
authors.lastname: Peter
authors.forename: Philip
authors.initials: P
authors.lastname: Robinson
authors.forename: Karin
authors.initials: K
authors.lastname: Martin-Latry
authors.forename: Mathieu
authors.initials: M
authors.lastname: Molimard
mesh_terms: D000280:Administration, Inhalation; D000293:Adolescent; D000318:Adrenergic beta-Agonists / Q000627:therapeutic use; D000328:Adult; D001249:Asthma; D004359:Drug Therapy, Combination; D004363:Drug Utilization; D005260:Female; D005602:France; D005938:Glucocorticoids / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D007345:Insurance Claim Review; D020024:Leukotriene Antagonists / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance
chemical_list: D000318:Adrenergic beta-Agonists; D005938:Glucocorticoids; D020024:Leukotriene Antagonists