Adherence to controller asthma medications: 6-month prevalence across a US community pharmacy chain.
OBJECTIVE
Non-adherence to controller asthma medications is an important public health problem. It is estimated to occur in 30-70% of individuals and is a significant risk factor for asthma morbidity and mortality. The aim of this study was to determine the level of adherence, as indicated by refill rates, to controller asthma medications in a community pharmacy setting.


METHODS
Secondary analyses of a community pharmacy dispensing database in 15 locations throughout Utah.


CONCLUSIONS
The dispensing records of 2193 patients who received controller medications for asthma in a 12-month period, and had a minimum of 6-month potential coverage (180 days) from the date of their first receipt of a controller medication in that period, were examined. Using standard metrics to gauge adherence, the proportion of days covered (PDC) and the medication possession ratio (MPR), the average coverage for controller asthma medications across a 6-month period (180 days) was poor, averaging less than 50% of days' availability. Standard cut-offs (≥80% medication availability) indicated that only 14-16% of patients had 'satisfactory' adherence over their 6-month follow-on period. Females and older patients had significantly greater satisfactory adherence. Medication adherence was significantly greater with inhaled corticosteroid (ICS)-long-acting β2-agonist (LABA) combinations than with ICS alone.


CONCLUSIONS
This study confirms the considerable scope of the asthma therapy non-adherence problem. Therefore, it is imperative to conduct survey-based research linked directly to pharmacy-based dispensing data to derive patient behavioural, attitudinal and environmental factors that may contribute to the issue, and then pilot and evaluate interventions for change.
Department of Pharmacotherapy, College of Pharmacy, University of Utah, Salt Lake City, UT, USA.
M
http://orcid.org/0000-0002-3921-1089
M
Feehan
Hall & Partners, New York, NY, USA.
L
L
Ranker
Hall & Partners, New York, NY, USA.
R
R
Durante
Hall & Partners, New York, NY, USA.
D K
DK
Cooper
Harmon City Inc., West Valley City, UT, USA.
G J
GJ
Jones
Department of Pharmacotherapy, College of Pharmacy, University of Utah, Salt Lake City, UT, USA.
D C
DC
Young
Department of Pharmacotherapy, College of Pharmacy, University of Utah, Salt Lake City, UT, USA.
M A
MA
Munger
adherence; asthma