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Improved refill persistence with fluticasone propionate and salmeterol in a single inhaler compared with other controller therapies.
J Allergy Clin Immunol. 2004 Feb; 113(2):245-51.JA

Abstract

BACKGROUND

Improved adherence to inhaled corticosteroids (ICSs) has also been associated with decreased asthma-associated morbidity and mortality.

OBJECTIVE

The purpose of this study was to assess patient medication refill persistence with fluticasone propionate (FP) and salmeterol combination in a single inhaler (FSC), FP and salmeterol in combination from 2 separate inhalers, FP and montelukast in combination, FP as monotherapy, and montelukast as monotherapy.

METHODS

We performed a retrospective, observational, 24-month (12-month baseline and 12-month follow-up) database study using medical and pharmacy claims from a large managed care organization. We identified 2511 subjects 12 years of age or older with a claim for asthma (International Classification of Diseases, Ninth Revision: 493.XX): 563 patients receiving FSC, 224 receiving FP plus salmeterol, 75 receiving FP plus montelukast, 798 receiving FP only, and 776 receiving montelukast only. Refill rates of FP, as a measure of adherence, were compared for each FP-containing cohort during the 12-month follow-up period. In addition, refill rates were compared between FSC, an inhaler, and montelukast, an oral medication.

RESULTS

Twelve-month baseline asthma medication use and patient demographics were comparable among cohorts. Patients in the FSC cohort obtained significantly more refills compared with the number of FP refills in the other FP-containing cohorts (4.06 for FSC vs 2.35 for FP plus salmeterol, 1.83 for FP plus montelukast, and 2.27 for FP alone) over the 12-month follow-up period. In addition, patients taking FSC had similar refill persistence compared with patients taking the oral leukotriene modifier montelukast (4.51).

CONCLUSION

FSC might increase ICS refill persistence compared with FP alone in a single inhaler, FP in combination with salmeterol from 2 separate inhalers, and FP in combination with montelukast. In addition, FSC in a dry powdered inhaler had similar refill rates compared with an oral asthma agent, montelukast. Use of a single inhaler containing both an ICS (FP) and a long-acting bronchodilator (salmeterol) might increase the likelihood that patients are getting more optimal ICS therapy, as well as the benefits from the long-acting bronchodilator, with patient adherence comparable to an oral agent.

Authors+Show Affiliations

University of Nevada School of Medicine, Reno, Nev, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

14767437

Citation

Stoloff, Stuart W., et al. "Improved Refill Persistence With Fluticasone Propionate and Salmeterol in a Single Inhaler Compared With Other Controller Therapies." The Journal of Allergy and Clinical Immunology, vol. 113, no. 2, 2004, pp. 245-51.
Stoloff SW, Stempel DA, Meyer J, et al. Improved refill persistence with fluticasone propionate and salmeterol in a single inhaler compared with other controller therapies. J Allergy Clin Immunol. 2004;113(2):245-51.
Stoloff, S. W., Stempel, D. A., Meyer, J., Stanford, R. H., & Carranza Rosenzweig, J. R. (2004). Improved refill persistence with fluticasone propionate and salmeterol in a single inhaler compared with other controller therapies. The Journal of Allergy and Clinical Immunology, 113(2), 245-51.
Stoloff SW, et al. Improved Refill Persistence With Fluticasone Propionate and Salmeterol in a Single Inhaler Compared With Other Controller Therapies. J Allergy Clin Immunol. 2004;113(2):245-51. PubMed PMID: 14767437.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Improved refill persistence with fluticasone propionate and salmeterol in a single inhaler compared with other controller therapies. AU - Stoloff,Stuart W, AU - Stempel,David A, AU - Meyer,Jay, AU - Stanford,Richard H, AU - Carranza Rosenzweig,Jacqueline R, PY - 2004/2/10/pubmed PY - 2004/3/18/medline PY - 2004/2/10/entrez SP - 245 EP - 51 JF - The Journal of allergy and clinical immunology JO - J Allergy Clin Immunol VL - 113 IS - 2 N2 - BACKGROUND: Improved adherence to inhaled corticosteroids (ICSs) has also been associated with decreased asthma-associated morbidity and mortality. OBJECTIVE: The purpose of this study was to assess patient medication refill persistence with fluticasone propionate (FP) and salmeterol combination in a single inhaler (FSC), FP and salmeterol in combination from 2 separate inhalers, FP and montelukast in combination, FP as monotherapy, and montelukast as monotherapy. METHODS: We performed a retrospective, observational, 24-month (12-month baseline and 12-month follow-up) database study using medical and pharmacy claims from a large managed care organization. We identified 2511 subjects 12 years of age or older with a claim for asthma (International Classification of Diseases, Ninth Revision: 493.XX): 563 patients receiving FSC, 224 receiving FP plus salmeterol, 75 receiving FP plus montelukast, 798 receiving FP only, and 776 receiving montelukast only. Refill rates of FP, as a measure of adherence, were compared for each FP-containing cohort during the 12-month follow-up period. In addition, refill rates were compared between FSC, an inhaler, and montelukast, an oral medication. RESULTS: Twelve-month baseline asthma medication use and patient demographics were comparable among cohorts. Patients in the FSC cohort obtained significantly more refills compared with the number of FP refills in the other FP-containing cohorts (4.06 for FSC vs 2.35 for FP plus salmeterol, 1.83 for FP plus montelukast, and 2.27 for FP alone) over the 12-month follow-up period. In addition, patients taking FSC had similar refill persistence compared with patients taking the oral leukotriene modifier montelukast (4.51). CONCLUSION: FSC might increase ICS refill persistence compared with FP alone in a single inhaler, FP in combination with salmeterol from 2 separate inhalers, and FP in combination with montelukast. In addition, FSC in a dry powdered inhaler had similar refill rates compared with an oral asthma agent, montelukast. Use of a single inhaler containing both an ICS (FP) and a long-acting bronchodilator (salmeterol) might increase the likelihood that patients are getting more optimal ICS therapy, as well as the benefits from the long-acting bronchodilator, with patient adherence comparable to an oral agent. SN - 0091-6749 UR - https://www.unboundmedicine.com/medline/citation/14767437/Improved_refill_persistence_with_fluticasone_propionate_and_salmeterol_in_a_single_inhaler_compared_with_other_controller_therapies_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0091674903024485 DB - PRIME DP - Unbound Medicine ER -