Adherence to inhaled therapy, mortality and hospital admission in COPD

J. Vestbo, J. A. Anderson, P. M A Calverley, B. Celli, G. T. Ferguson, C. Jenkins, K. Knobil, L. R. Willits, J. C. Yates, P. W. Jones

    Research output: Contribution to journalArticlepeer-review

    Abstract

    Background: Little is known about adherence to inhaled medication in chronic obstructive pulmonary disease (COPD) and the impact on mortality and morbidity. Methods: Data on drug adherence from a randomised double-blind trial comparing inhaled salmeterol 50 μg + fluticasone propionate 500 mg twice daily with placebo and each drug individually in 6112 patients with moderate to severe COPD over 3 years in the TORCH study were used. All-cause mortality and exacerbations leading to hospital admission were primary and secondary end points. The study of adherence was not specified a priori as an ancillary study. Results: Of the 4880 patients (79.8%) with good adherence defined as .80% use of study medication, 11.3% died compared with 26.4% of the 1232 patients (20.2%) with poor adherence. The annual rates of hospital admission for exacerbations were 0.15 and 0.27, respectively. The association between adherence and mortality remained unchanged and statistically significant after adjusting for other factors related to prognosis (hazard ratio 0.40 (95% CI 0.35 to 0.46), p
    Original languageEnglish
    Pages (from-to)939-943
    Number of pages4
    JournalThorax
    Volume64
    Issue number11
    DOIs
    Publication statusPublished - Nov 2009

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