Original Article
Longitudinal association between medication adherence and lung health in people with cystic fibrosis,☆☆,,★★,☆☆☆,☆☆☆☆,★★★

https://doi.org/10.1016/j.jcf.2011.03.005Get rights and content
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Abstract

Background

This study examined the relationship of medication adherence to frequency of pulmonary exacerbation and rate of decline in FEV1% predicted (FEV1).

Methods

95 CF patients aged 6 years or older and prescribed a pulmonary medication, were enrolled in a longitudinal retrospective review of medication adherence and health outcomes (the occurrence and frequency of intravenous (IV) antibiotic treatments and FEV1) over 12-months. Pharmacy refill records were used to calculate a medication possession ratio (MPR).

Results

Composite MPR predicted the occurrence of at least one pulmonary exacerbation requiring a course of IV antibiotics (IRR = 2.34, p = 0.05), but not the frequency of exacerbations, after controlling for gender, baseline FEV1, and regimen complexity. Composite MPR predicted baseline FEV1 (estimate = 29.81, p = .007), but not decline in FEV1.

Conclusions

These results demonstrate a significant relation between medication adherence and IV antibiotics in CF patients, highlighting the importance of addressing adherence during clinic visits to improve health outcomes.

Abbreviations

BMI
body mass index
FEV1
forced expiratory volume in the first second
HLM
hierarchical linear model
IRR
incidence rate ratio
IQR
interquartile range
MPR
medication possession ratio
PFT
pulmonary function test
SD
standard deviation

Keywords

Adherence
Cystic fibrosis
Health outcomes
Treatment
Pulmonary exacerbation

Cited by (0)

Funding sources: NHLBI Grants R01 HL087997 and K23 HL075344.

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Work was performed at The Johns Hopkins School of Medicine, Johns Hopkins University.

Dr. Eakin has no conflict of interest to disclose.

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Mr. Bilderback has no conflict of interest to disclose.

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Dr. Boyle has no conflict of interest to disclose.

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Dr. Mogayzel has no conflict of interest to disclose.

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Dr. Riekert has no conflict of interest to disclose.