June 27, 1994

Comparison of Patients' Compliance With Prescribed Oral and Inhaled Asthma Medications

Author Affiliations

From the Asthma and Allergy Research Center (Drs Kelloway and Wyatt) and the Health Research Center (Ms Adlis), Park Nicollet Medical Center and Park Nicollet Medical Foundation, Minneapolis, Minn.

Arch Intern Med. 1994;154(12):1349-1352. doi:10.1001/archinte.1994.00420120066007

Background:  Noncompliance with medications is one of the most serious problems facing health care today. However, methods to measure compliance have many limitations.

Methods:  To measure specific drug compliance and dosing frequency of two asthma medications, we used medical records data and pharmacy claims data from 276 patients who had concurrent prescriptions for inhaled anti-inflammatory agents and oral theophylline. Patients were randomly selected from the pharmacy claims data files of a health maintenance organization. The patients' medical records were reviewed, and records that did not contain clear documentation of the medication, dose, and dosing frequency were excluded. Data from the remaining 119 medical records were compared with data from pharmacy claims to calculate compliance rates for each medication.

Results:  Our calculations showed that patients were significantly more compliant with prescribed theophylline medication than with two inhaled anti-inflammatory medications (P=.0001). No significant differences in compliance were found relative to prescribed dosing frequency (twice daily or less compared with three times daily or more) for either medication (P=.6517).

Conclusions:  Comparison of medical record data with pharmacy claims data is an effective indirect measure of patients' compliance with prescribed oral theophylline and inhaled anti-inflammatory agents. Additional interventions must be pursued for patients with asthma regarding adherence to regimens for their prescribed inhaled anti-inflammatory agents.(Arch Intern Med. 1994;154:1349-1352)