Clinical and economic impact of non-adherence in COPD: A systematic review

• Published in: Respiratory medicine Vol. 108; no. 1; pp. 103 - 113
• Main Authors: van Boven, Job F.M, Chavannes, Niels H, van der Molen, Thys, Rutten-van Mölken, Maureen P.M.H, Postma, Maarten J, Vegter, Stefan
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01-01-2014; Elsevier Limited
• Subjects: Adherence; Algorithms; Chronic obstructive pulmonary disease; Clinical trials; Compliance; COPD; Drug therapy; Economics; Efficiency; Evidence-Based Medicine; Hospital costs; Hospitalization; Humans; Length of Stay - economics; Mortality; Outcomes; Patient Compliance; Pulmonary Disease, Chronic Obstructive - drug therapy; Pulmonary Disease, Chronic Obstructive - economics; Pulmonary Disease, Chronic Obstructive - mortality; Pulmonary/Respiratory; Quality of Life; Studies; Netherlands; Adherence; Economics; Outcomes; COPD
• ISSN: 0954-6111; 1532-3064
• DOI: 10.1016/j.rmed.2013.08.044

Summary Background Medication for Chronic Obstructive Pulmonary Disease (COPD) has shown to substantially reduce symptoms and slow progression of disease. However, non-adherence to medication is common and associated with worsened clinical and economic outcomes. Objective The objective of this study was to perform a systematic review of published literature to assess the impact of non-adherence to COPD medication on clinical and economic outcomes. Methods A search in PubMed and Web of Science databases was conducted of original studies published from database inception to 2012. Studies must report on the association between adherence to COPD medication and outcomes, published in English in peer-reviewed journals and full texts needed to be available. Results Twelve full articles were included in the review. Most studies were retrospective database studies. Seven studies reported on the association between adherence and clinical outcomes, two on mortality, three on costs, four on quality of life and one on work productivity. Results indicated a clear association between adherence and both clinical and economic outcomes. Evidence from studies revealed increased hospitalizations, mortality, quality of life and loss of productivity among non-adherent patients. Conclusion This review revealed a clear association between non-adherence to COPD medication and worsened clinical and economic outcomes making non-adherent patients a priority for cost-effective interventions.