Comparative adherence and persistence of single-inhaler and multiple-inhaler triple therapies among patients with chronic obstructive pulmonary disease in Japan: a retrospective cohort study

Objectives To evaluate and compare medication adherence and persistence for patients newly initiating single-inhaler triple therapy (SITT) and multiple-inhaler triple therapy (MITT) for chronic obstructive pulmonary disease (COPD) in Japan.Design Retrospective, new-user, active comparator, observati...

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Main Authors: Olivia Massey, Robert Wood, Kieran J Rothnie, TAKEO ISHII, Alexandrosz Czira, Chris Compton, Afisi Ismaila, Sandra Jokšaitė, Lucinda Camidge, Akiko Mizukami, Masao Yarita, Rad Siddiqui, Thomas Jennison, Kenichi Hashimoto
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Language:English
Published: BMJ Publishing Group 2024-12-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/14/12/e080864.full
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author Olivia Massey
Robert Wood
Kieran J Rothnie
TAKEO ISHII
Alexandrosz Czira
Chris Compton
Afisi Ismaila
Sandra Jokšaitė
Lucinda Camidge
Akiko Mizukami
Masao Yarita
Rad Siddiqui
Thomas Jennison
Kenichi Hashimoto
author_facet Olivia Massey
Robert Wood
Kieran J Rothnie
TAKEO ISHII
Alexandrosz Czira
Chris Compton
Afisi Ismaila
Sandra Jokšaitė
Lucinda Camidge
Akiko Mizukami
Masao Yarita
Rad Siddiqui
Thomas Jennison
Kenichi Hashimoto
author_sort Olivia Massey
collection DOAJ
description Objectives To evaluate and compare medication adherence and persistence for patients newly initiating single-inhaler triple therapy (SITT) and multiple-inhaler triple therapy (MITT) for chronic obstructive pulmonary disease (COPD) in Japan.Design Retrospective, new-user, active comparator, observational cohort study using inverse probability of treatment weighting.Setting Health insurance claims data from the Medical Data Vision Co., Ltd, hospital claims database.Participants Adults diagnosed with COPD at age ≥40 years newly initiating MITT or SITT (fluticasone furoate/umeclidinium/vilanterol (FF/UMEC/VI) or formoterol fumarate/budesonide/glycopyrronium) from 1 September 2019 to 31 July 2021.Primary and secondary outcome measures The primary outcome was medication adherence compared between patients using SITT and MITT, assessed by the proportion of days covered ≥80%. Secondary outcomes included medication persistence (time from index treatment initiation to discontinuation) compared between patients using SITT and MITT and medication adherence compared before and after the switch in a subgroup of patients switching from MITT to SITT.Results We included 2575 MITT and 2962 SITT users with similar baseline characteristics following weighting. The proportion of adherent patients was significantly greater for SITT versus MITT users at 6 months (19.7% vs 10.2%, p<0.0001), 12 months (6.0% vs 3.8%, p=0.0009) and 18 months (3.8% vs 1.4%, p<0.0001) post-index. Median persistence was also significantly higher for SITT versus MITT users (2.0 vs 1.0 months, p<0.001). Comparing specific SITT versus MITT, the proportion of adherent patients at each time point and median persistence was greater for FF/UMEC/VI. In patients switching from MITT to SITT (n=688), the proportion of adherent patients increased postswitch at the class level and for FF/UMEC/VI specifically.Conclusions Patients with COPD in Japan who were newly initiating SITT had greater medication adherence and persistence compared with those on MITT up to 18 months following initiation.
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spelling doaj-art-12599d1d4cde422b9a719a46a95ffbd32025-08-20T02:49:17ZengBMJ Publishing GroupBMJ Open2044-60552024-12-01141210.1136/bmjopen-2023-080864Comparative adherence and persistence of single-inhaler and multiple-inhaler triple therapies among patients with chronic obstructive pulmonary disease in Japan: a retrospective cohort studyOlivia Massey0Robert Wood1Kieran J Rothnie2TAKEO ISHII3Alexandrosz Czira4Chris Compton5Afisi Ismaila6Sandra Jokšaitė7Lucinda Camidge8Akiko Mizukami9Masao Yarita10Rad Siddiqui11Thomas Jennison12Kenichi Hashimoto132 Real-world Evidence, Adelphi Real World, Bollington, Cheshire, UK2 Real-world Evidence, Adelphi Real World, Bollington, Cheshire, UK1 Value Evidence and Outcomes, R&D Global Medical, GlaxoSmithKline, London, UK5 Value Evidence and Outcomes, Japan Medical and Development, GlaxoSmithKline, Tokyo, Japan1 Value Evidence and Outcomes, R&D Global Medical, GlaxoSmithKline, London, UK6 Global Medical, GlaxoSmithKline, London, UK3 Value Evidence and Outcomes, R&D Global Medical, GlaxoSmithKline, Collegeville, Pennsylvania, USA1 Value Evidence and Outcomes, R&D Global Medical, GlaxoSmithKline, London, UK2 Real-world Evidence, Adelphi Real World, Bollington, Cheshire, UK5 Value Evidence and Outcomes, Japan Medical and Development, GlaxoSmithKline, Tokyo, Japan5 Value Evidence and Outcomes, Japan Medical and Development, GlaxoSmithKline, Tokyo, Japan2 Real-world Evidence, Adelphi Real World, Bollington, Cheshire, UK2 Real-world Evidence, Adelphi Real World, Bollington, Cheshire, UK5 Value Evidence and Outcomes, Japan Medical and Development, GlaxoSmithKline, Tokyo, JapanObjectives To evaluate and compare medication adherence and persistence for patients newly initiating single-inhaler triple therapy (SITT) and multiple-inhaler triple therapy (MITT) for chronic obstructive pulmonary disease (COPD) in Japan.Design Retrospective, new-user, active comparator, observational cohort study using inverse probability of treatment weighting.Setting Health insurance claims data from the Medical Data Vision Co., Ltd, hospital claims database.Participants Adults diagnosed with COPD at age ≥40 years newly initiating MITT or SITT (fluticasone furoate/umeclidinium/vilanterol (FF/UMEC/VI) or formoterol fumarate/budesonide/glycopyrronium) from 1 September 2019 to 31 July 2021.Primary and secondary outcome measures The primary outcome was medication adherence compared between patients using SITT and MITT, assessed by the proportion of days covered ≥80%. Secondary outcomes included medication persistence (time from index treatment initiation to discontinuation) compared between patients using SITT and MITT and medication adherence compared before and after the switch in a subgroup of patients switching from MITT to SITT.Results We included 2575 MITT and 2962 SITT users with similar baseline characteristics following weighting. The proportion of adherent patients was significantly greater for SITT versus MITT users at 6 months (19.7% vs 10.2%, p<0.0001), 12 months (6.0% vs 3.8%, p=0.0009) and 18 months (3.8% vs 1.4%, p<0.0001) post-index. Median persistence was also significantly higher for SITT versus MITT users (2.0 vs 1.0 months, p<0.001). Comparing specific SITT versus MITT, the proportion of adherent patients at each time point and median persistence was greater for FF/UMEC/VI. In patients switching from MITT to SITT (n=688), the proportion of adherent patients increased postswitch at the class level and for FF/UMEC/VI specifically.Conclusions Patients with COPD in Japan who were newly initiating SITT had greater medication adherence and persistence compared with those on MITT up to 18 months following initiation.https://bmjopen.bmj.com/content/14/12/e080864.full
spellingShingle Olivia Massey
Robert Wood
Kieran J Rothnie
TAKEO ISHII
Alexandrosz Czira
Chris Compton
Afisi Ismaila
Sandra Jokšaitė
Lucinda Camidge
Akiko Mizukami
Masao Yarita
Rad Siddiqui
Thomas Jennison
Kenichi Hashimoto
Comparative adherence and persistence of single-inhaler and multiple-inhaler triple therapies among patients with chronic obstructive pulmonary disease in Japan: a retrospective cohort study
BMJ Open
title Comparative adherence and persistence of single-inhaler and multiple-inhaler triple therapies among patients with chronic obstructive pulmonary disease in Japan: a retrospective cohort study
title_full Comparative adherence and persistence of single-inhaler and multiple-inhaler triple therapies among patients with chronic obstructive pulmonary disease in Japan: a retrospective cohort study
title_fullStr Comparative adherence and persistence of single-inhaler and multiple-inhaler triple therapies among patients with chronic obstructive pulmonary disease in Japan: a retrospective cohort study
title_full_unstemmed Comparative adherence and persistence of single-inhaler and multiple-inhaler triple therapies among patients with chronic obstructive pulmonary disease in Japan: a retrospective cohort study
title_short Comparative adherence and persistence of single-inhaler and multiple-inhaler triple therapies among patients with chronic obstructive pulmonary disease in Japan: a retrospective cohort study
title_sort comparative adherence and persistence of single inhaler and multiple inhaler triple therapies among patients with chronic obstructive pulmonary disease in japan a retrospective cohort study
url https://bmjopen.bmj.com/content/14/12/e080864.full
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