Source: Annual Congress 2002 - Asthma in primary care - Assessment and control
Disease area: Airway diseases

Abstract

Background : Leukotriene receptor antagonists (LTRAs) and inhaled corticosteroids (ICs) represent two classes of asthma controller medications. To control asthma, these drugs must be taken continuously. Objective : To study patients' persistence to treatment with LTRAs and ICs. Methods : Two cohorts of 15 to 45 years old patients with asthma were selected from the Quebec Health Insurance Plan Database. Patients who filled at least one prescription for a LTRA between January 1, 1998 and December 31, 2000 but no prescription for a LTRA in 1997 were included in the LTRA cohort, regardless of whether they were also prescribed an IC at any point in time. Patients who received at least one prescription for an IC between January 1, 1998 and December 31, 2000 but no prescription for an IC or a LTRA in 1997 were included in the IC cohort. The index date was defined by the date of the first LTRA or IC prescription. Persistence to therapies were compared using Cox proportional hazards models. Results : A total of 2,708 patients were included in the LTRA cohort and 20,157 in the IC cohort. In the LTRA cohort, 70% of patients refilled their prescription at least once and 27% were still on treatment one year after the index date. In the IC cohort, the corresponding figures were 38% and 5%. Persistence was significantly better for LTRAs than for ICs (rate ratio of treatment failure [RR], 0.48; 95% confidence interval [CI], 0.45-0.51) and, in the LTRA cohort, significantly better for montelukast than for zafirlukast (RR, 0.43; 95% CI, 0.39-0.48). Conclusion : Persistence to LTRAs and ICs in patients with asthma is far from optimal and needs to be improved. The superior persistence to LTRAs might result in better [dsquote]real-life[dsquote] effectiveness.

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Citations should be made in the following way:
M. Dorais, L. Blais, I. Chabot, J. LeLorier (Montreal, Canada). Persistence to asthma controller therapies in Quebec adult patients. Eur Respir J 2002; 20: Suppl. 38, 583

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