Overlap of Nonadherence to COPD Medications and Other Chronic Disease Medications

Adherence to medications can be an issue in all disease types, but it’s especially challenging in chronic obstructive pulmonary disease (COPD). While there are medications available to control symptoms of COPD, reduce exacerbations, and improve the overall health status of patients, medication adherence for COPD remains well below the average level.

Some previously established reasons for low adherence to COPD medications are the daily variations in symptoms, patient knowledge and beliefs, socioeconomic factors, and the fact that COPD patients often have other comorbidities. Since patients with COPD often have other comorbidities, researchers sought to understand patient adherence to maintenance COPD (mCOPD) medications and adherence to treat other chronic conditions. The study was published in the International Journal of COPD

“Understanding the relationship may provide further insight into the reasons for suboptimal adherence rates for COPD medications,” the authors wrote.

The researchers studied claims data from the Humana Research Database from January 1, 2008, to December 31, 2012. Patients in the study had a COPD diagnosis and were required to initiate mCOPD medication within 1 year of diagnosis.

The authors found that less than one-fourth (20.8%) of patients were considered adherent based on the proportion of days covered. In addition, they found significant differences between patients who were adherence and patients who were not adherent based on geographical location, comorbidity burden, and influenza vaccination status. Nonadherence patients were more likely to live in the south, had a greater comorbidity burden, and were less likely to have the recommended frequency of flu vaccinations.

Looking at adherence to other chronic conditions, the authors found that nonadherence to antidepressants, antihypertensives, oral antyhyperglycemics, beta-blockers, bisphosphonates, calcium channel blockers, diuretics, insulins, nonsteroidal anti-inflammatory medications, and statins were each associated with increases nonadherence to COPD medications. Meanwhile, nonadherence to anticoagulants and antianxiety medications was not associated with nonadherence to COPD medications.

The findings imply that factors impacting adherence do not change by medication type. As such, patient counseling tools could influence behavior to improve adherence regardless of the medication type, the authors determined.

“The results of this study suggest that there is a positive association between non-adherence (or adherence) to mCOPD medications and non-adherence (or adherence) to non-COPD medications, ie, patients that are likely to be non-adherent (or adherent) to mCOPD medication are also likely to be non-adherent (or adherent) to non-COPD medications,” the authors concluded.