Impact of Single Combination Inhaler versus Multiple Inhalers to Deliver the Same Medications for Patients with Asthma or COPD: A Systematic Literature Review

• Autor: Zhang, Shiyuan ; King, Denise ; Rosen, Virginia M ; Ismaila, Afisi S
• Materias: Administration, Inhalation ; Aerosols ; Analysis ; Asthma ; Asthma - diagnosis ; Asthma - drug therapy ; Asthma - economics ; Asthma - physiopathology ; asthma exacerbations ; Bronchodilator Agents - administration & dosage ; Bronchodilator Agents - adverse effects ; Bronchodilator Agents - economics ; Chronic obstructive pulmonary disease ; copd exacerbations ; Cost analysis ; Cost Savings ; Cost-Benefit Analysis ; cost-effectiveness ; Diseases ; Drug Combinations ; Drug Costs ; Drug dosages ; Drug therapy ; Drug Therapy, Combination ; Drugs ; Health care costs ; Health care expenditures ; Health care reform ; health-related quality of life ; Humans ; Inhalers ; Literature reviews ; Lung - drug effects ; Lung - physiopathology ; Lung diseases ; lung function ; Medical care, Cost of ; Nebulizers and Vaporizers ; Patient compliance ; Patients ; Pharmaceutical industry ; Political activity ; Political aspects ; Prescriptions ; Pulmonary Disease, Chronic Obstructive - diagnosis ; Pulmonary Disease, Chronic Obstructive - drug therapy ; Pulmonary Disease, Chronic Obstructive - economics ; Pulmonary Disease, Chronic Obstructive - physiopathology ; Quality of life ; Respiratory agents ; Respiratory system agents ; Review ; Systematic review ; Treatment Outcome
• Es parte de: International journal of chronic obstructive pulmonary disease, 2020-02, Vol.15, p.417-438
• Descripción: With increasing choice of medications and devices for asthma and chronic obstructive pulmonary disease (COPD) treatment, comparative evidence may inform treatment decisions. This systematic literature review assessed clinical and economic evidence for using a single combination inhaler versus multiple inhalers to deliver the same medication for patients with asthma or COPD. In 2016, Embase, PubMed and the Cochrane library were searched for publications reporting studies in asthma or COPD comparing a single-inhaler combination medicine with multiple inhalers delivering the same medication. Publications included English-language articles published since 1996 and congress abstracts since 2013. Clinical, economic and adherence endpoints were assessed. Of 2031 abstracts screened, 18 randomized controlled trials (RCTs) in asthma and four in COPD, nine retrospective and three prospective observational studies in asthma, and four observational studies in COPD were identified. Of these, five retrospective and one prospective study in asthma, and two retrospective studies in COPD reported greater adherence with a single inhaler than multiple inhalers. Nine observational studies reported significantly (n=7) or numerically (n=2) higher rates of adherence with single- versus multiple-inhaler therapy. Economic analyses from retrospective and prospective studies showed that use of single-inhaler therapies was associated with reduced healthcare resource use (n=6) and was cost-effective (n=5) compared with multiple-inhaler therapies. Findings in 18 asthma RCTs and one prospective study reporting lung function, and six RCTs reporting exacerbation rates, showed no significant differences between a single inhaler and multiple inhalers. This was in contrast to several observational studies reporting reductions in healthcare resource use or exacerbation events with single-inhaler treatment, compared with multiple inhalers. Retrospective and prospective studies showed that single-inhaler use was associated with decreased healthcare resource utilization and improved cost-effectiveness compared with multiple inhalers. Lung function and exacerbation rates were mostly comparable in the RCTs, possibly due to study design.
  
• Editor: New Zealand: Dove Medical Press Limited
  
• Idioma: Inglés