Effect of salmeterol on patients' adherence to their prescribed refills for inhaled corticosteroids

Background: Optimal treatment for persistent asthma requires multiple class es of medication, including antiinflammatory agents and bronchodilators. In haled corticosteroids are the most effective antiinflammatory agents availa ble and are recommended by recent guidelines as first-line treatment. Salme terol, a long-acting inhaled bronchodilator, is recommended as adjunctive t herapy to inhaled corticosteroids. Non-adherence to prescribed medication i s prevalent and has been implicated in asthma exacerbations. Salmeterol's b enefits in terms of asthma control are readily perceived by patients wherea s the benefits of inhaled corticosteroid therapy may be less apparent. Objective: To evaluate whether the addition of salmeterol to a medication r egimen affects patient adherence to prescription refills for inhaled cortic osteroids. Methods: A retrospective medical chart and pharmacy claims record review be fore and after the addition of salmeterol was used. Medication adherence ra tes were calculated for 67 patients requiring inhaled corticosteroids for a t least 8 months before and after the addition of salmeterol. Results: Adherence with inhaled corticosteroid therapy before (49.7% +/- 29 .3%) and after (56.5% +/- 28.6%) the introduction of salmeterol was not sig nificantly different (P = .0785, pre versus post). Adherence with salmetero l was significantly higher (58.7% +/- 28.3%) than inhaled corticosteroids a t baseline (P = .0202), but not with concurrent use. Dosing frequency of in haled corticosteroid administration was not a significant factor in adheren ce, but increasing age was (r = 0.41788, P = .0048). Conclusions: The addition of salmeterol does not adversely affect the adher ence rates to prescription refills for prescribed inhaled corticosteroid th erapy. On average, important antiinflammatory treatment should not be suppl anted with salmeterol if prescribed in combination.