Impact of coronavirus disease 2019 on adherence to chronic obstructive pulmonary disease and asthma maintenance medications in the united states

SESSION TITLE: Obstructive Lung Disease Posters 7 SESSION TYPE: Original Investigation Posters PRESENTED ON: 10/11/2023 12:00 pm - 12:45 pm PURPOSE: Poor adherence to healthcare practitioner-prescribed inhaled respiratory maintenance therapy may increase mortality, morbidity and hospitalizations, and lead to a reduced quality of life. Coronavirus disease 2019 (COVID-19)-related disruptions impacted healthcare utilization patterns and medication adherence may have been affected. Up-to-date data on the impact of the COVID-19 pandemic on chronic obstructive pulmonary disease (COPD) and asthma medication adherence is needed. This study describes current trends in medication adherence among patients with COPD and asthma before and throughout dynamic pandemic periods (e.g., government shutdowns, availability of vaccinations, emergence of new variants). METHODS: This retrospective longitudinal cohort study used the Optum Research Database to identify patients aged ≥18 years with ≥2 separate asthma diagnoses and patients aged ≥40 years with ≥2 separate COPD diagnoses who were treated with maintenance therapy and continuously enrolled for a 12-month baseline period. Patients were followed from January 2018 until disenrollment or study end in May 2022. Adherence was assessed using the proportion of days covered (PDC), calculated as the number of days for which any maintenance medication was available divided by the number of days in the same time period. PDC was assessed overall and by medication class both monthly and annually. All outcomes were analyzed descriptively. RESULTS: For the 139,128 patients with COPD, mean annual PDC was consistent across the follow-up period (2018: 0.54, [standard deviation, SD: 0.38] to 2021: 0.55 [SD: 0.41]). Following the start of the pandemic period in March 2020, monthly mean PDC reached a maximum of 0.56 (SD: 0.47) in April 2020. For the 143,053 patients with asthma, mean annual PDC across all asthma medications was consistent from 2018–2021 (2018: 0.57 [SD: 0.39] to 2021: 0.58 [SD: 0.42]). During the pandemic period, mean monthly PDC reached a maximum of 0.60 (SD: 0.46) in April 2020. For both asthma and COPD, PDC remained consistent within maintenance therapy classes, with the exception of single-inhaler triple therapy, which increased marginally across the follow-up period, corresponding with increased availability. CONCLUSIONS: PDC remained relatively consistent for asthma and COPD maintenance therapies before and during the pandemic. CLINICAL IMPLICATIONS: While PDC appeared to increase temporarily at the onset of the pandemic, PDC with asthma and COPD-related medications did not show pandemic-related impact in terms of treatment interruption or increased patient focus. DISCLOSURES: Employee relationship with Optum Please note: AUG2009 to current Added 03/31/2023 by Tim Bancroft, source=Web Response, value=Salary Stock/stock options relationship with GSK Please note: 06/04/2023 Added 04/06/2023 by Helen Birch, source=Web Response, value=stock options Employee relationship with GSK Please note: 06/04/2023 Added 04/06/2023 by Helen Birch, source=Web Response, value=Salary Employee relationship with GSK Please note: June 2014 to present Added 03/29/2023 by Christopher Compton, source=Web Response, value=I own shares in GSK No relevant relationships by Steve Gelwicks No disclosure on file for Afisi Ismaila Post-Doctoral Fellow sponsored by GSK relationship with GSK Please note: 07/01/22-06/01/24 Added 03/27/2023 by Lydia (Yejin) Lee, source=Web Response, value=Fellowship sponsorship Employee relationship with AstraZeneca Please note: 2018-2022 Added 04/03/2023 by Stephen Noorduyn, value=Salary Employee relationship with GSK Please note: 2022-current Added 04/03/2023 by Stephen Noorduyn, source=Web Response, value=Salary Stock owner relationship with Eli Lilly and Company Please note: 2008 - 09/15/2022 Added 04/07/2023 by Rosirene Paczkowski, source=Web Response, value=Stock Employee relationship with Eli Lilly and Company Please note: 2008 - 09/15/2022 Added 04/07/2023 by Rosirene Paczkowski, source=Web Response, value=Salary Stock owner relationship with GSK Please note: 09/16/2022- present Added 04/07/2023 by Rosirene Paczkowski, source=Web Response, value=Stock Employee relationship with GSK Please note: 09/16/2022 - present Added 04/07/2023 by Rosirene Paczkowski, source=Web Response, value=Salary No relevant relationships by Gema Requena Employee relationship with GlaxoSmithKline Please note: July 2019 to present by Kieran Rothnie, value=Salary No relevant relationships by Andrea Steffens