key: cord-1010343-o3jpv8lz
authors: Kaye, Leanne; Theye, Benjamin; Smeenk, Ian; Gondalia, Rahul; Barrett, Meredith A.; Stempel, David A.
title: Changes in medication adherence among patients with asthma and COPD during the COVID-19 pandemic
date: 2020-05-01
journal: J Allergy Clin Immunol Pract
DOI: 10.1016/j.jaip.2020.04.053
sha: 80eb4cc4056a5d6e28bc96af39be4c8b23250999
doc_id: 1010343
cord_uid: o3jpv8lz

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Leanne Kaye, PhD, MPH 1 6 Leanne.kaye@resmed.com 7 8

Benjamin Theye, BA, BS 2 9

Ben.theye@propellerhealth.com 10 11

Ian Smeenk, MS 2 12

Ian.smeenk@propellerhealth.com 13 14

Rahul Gondalia, Patients with asthma and COPD are advised to closely adhere to their prescribed inhaler 38 medication therapy due to the COVID-19 pandemic. Using electronic medication data, we 39 examined controller medication use and found positive increases in medication adherence. during the present pandemic may be driven by a patient's concern of their respiratory symptoms 47 being associated or confused with COVID-19. Patients with well managed symptoms are also 48 less likely to seek acute respiratory care at healthcare facilities and emergency departments, 49 which decreases the risk of incidental exposure to SARS-CoV-2 and allows healthcare providers 50 to focus attention on patients with other critical needs. (1) 51 52 In order to understand how patients with asthma and COPD were responding to the 53 recommendation of respiratory societies to follow daily medication regimens during the COVID-54 19 pandemic, we analyzed patient adherence to controller medication. Data was collected from 55 Propeller Health (Madison, WI), a digital platform that tracks inhaler use through electronic 56 medication monitors and sends alerts to patients for missed doses. This analysis was determined 57 to be exempt by the Copernicus IRB (PRH1-18-132). 58

We analyzed adherence to controller inhaler use for 7,578 patients (77% asthma, 67% females) 60 with a median (interquartile range) age of 40.0 (26.0-55.0) years. From the first seven days of 61 January 2020 to the last seven days of March 2020, there was a 14.5% increase (53.7% to 62 61.5%) in mean daily controller medication adherence, previously defined. (4) (Figure) We 63 noted similar increases in adherence across age groups with older patients having higher levels of 64 adherence. When adjusted for age, there were no clinically meaningful differences in adherence 65 for asthma or COPD patients. Additionally, during the last week of March, over 53% of patients 66 achieved ≥75% adherence to controller medications, a 14.9% increase from the first week of 67 January. We have previously reported changes in adherence by month. (7) In children, 4-17 68 years of age, there is a peak noted in September-October that has been temporally associated be reflective of patients responding to national COVID-19 guidelines (5) and to patient concern 74 about controlling their primary respiratory illness with their controller medications. Further, 75 patients with asthma and COPD that track their adherence to their controller medications may be 76 more motivated and achieve higher use of these medicines and therefore the findings may not be 77 generalizable to all patients. (6) Future analyses should also explore if medication adherence 78 changed during other recent pandemics like H1N1. This initial evidence on adherence is 79 encouraging during the first weeks of the COVID-19 and hopefully will have a positive effect on 80 improving control of asthma and COPD and minimize the need for acute care for their primary 81 respiratory disease. 82 83

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