TY - JOUR T1 - Impact of adherence to treatment with tiotropium co-administered with fluticasone propionate/salmeterol combination in COPD patients JF - European Respiratory Journal JO - Eur Respir J VL - 42 IS - Suppl 57 SP - P951 AU - Afisi Ismaila AU - John Sampalis AU - Diane Corriveau AU - Julie Vaillancourt AU - Daria Parsons AU - Anand Dalal AU - Zhen Su Y1 - 2013/09/01 UR - http://erj.ersjournals.com/content/42/Suppl_57/P951.abstract N2 - Introduction: Poor adherence to treatment has been considered a major factor contributing to sub-optimal COPD management.Objective: To assess the association between adherence to treatment and health care resource utilization (HCRU) in COPD patients treated with tiotropium (TIO) co-administered with fluticasone propionate / salmeterol combination (FSC).Methods: A retrospective observational cohort study utilizing administrative databases of the Quebec provincial health insurance of patients (age ≥40 years) with a diagnosis of COPD and ≥2 pharmacy claims for TIO + FSC dispensed from 1/1/2001 to 12/31/2010. Adherence to treatment was ascertained as compliance (medication possession ratio ≥80%) and persistence (no absence of treatment gap ≥30 days). Outcomes assessed were moderate exacerbations (ME), severe exacerbations (SE) and COPD HCRU. Multivariate logistic regression analyses (MLRA) were used to adjust for baseline characteristics.Results: A total of 11,148 subjects, proportions of compliant and persistent patients with TIO+FSC were 63% and 45% respectively. MLRA showed that adherence to TIO+FSC were associated with a significant (p<0.001) reduction in risk of ME and SE. The adjusted Odds Ratio for compliant patients were: TIO (ME = 0.449, SE = 0.570) and FSC (ME = 0.546; SE = 0.749). Similar results were seen for persistence. Compliance and persistence with TIO+FSC were also associated with significant (p<0.001) reduction in HCRU including rescue medication use and hospitalizationsConclusion: This study suggests that improved adherence to treatment with TIO+FSC is associated with decreased risk for exacerbations and lower HCRU in COPD patients. ER -