| アブストラクト | BACKGROUND: Longitudinal adherence patterns to LAMA/LABA therapy among middle-aged patients with COPD are not well understood. Because individuals aged 40-64 years typically self-manage medications with fewer age-related influences on adherence, this population allows clearer evaluation of temporal patterns. We therefore conducted a descriptive study among middle-aged patients to classify adherence trajectories and identify groups at risk of suboptimal adherence. METHODS: Using a Japanese claims database, we identified COPD patients aged 40-64 years who initiated glycopyrronium/indacaterol (GLY/IND), umeclidinium/vilanterol (UMEC/VI), or tiotropium/olodaterol (TIO/OLO). Group-based trajectory modeling was applied to the monthly proportion of days covered over 360 days to identify groups of patients with similar longitudinal adherence patterns. RESULTS: The analysis included 240 GLY/IND initiators, 365 UMEC/VI initiators, and 496 TIO/OLO initiators. For GLY/IND initiators, three adherence groups were identified: consistently high (31.7%), gradually declining (17.1%), and immediately declining (51.3%). UMEC/VI initiators demonstrated four groups: consistently high (26.6%), gradually declining (9.9%), rapidly declining (19.7%), and immediately declining (43.8%). TIO/OLO initiators also showed three groups: consistently high (35.5%), gradually declining (20.0%), and immediately declining (44.6%). Across all cohorts, higher adherence groups more frequently had a greater comorbidity burden and fewer previous moderate exacerbations, whereas suboptimal adherence groups tended to be younger, included more women, and initiated LAMA/LABA therapy in clinical settings. CONCLUSIONS: Middle-aged patients with COPD initiating LAMA/LABA therapy exhibited distinct adherence trajectories. Understanding these patterns may help inform more targeted approaches to support adherence and improve patient outcomes. |
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| ジャーナル名 | Respiratory investigation |
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| Pubmed追加日 | 2026/5/21 |
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| 投稿者 | Liu, Hao; Fukasawa, Toshiki; Miyamoto, Atsushi; Hirai, Kaho; Watanabe, Tetsuya; Asai, Kazuhisa; Akaike, Takenori; Yoshida, Satomi; Kawakami, Koji |
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| 組織名 | Department of Pharmacoepidemiology, Graduate School of Medicine and Public;Health, Kyoto University, Yoshidakonoe-cho, Sakyo-ku, Kyoto 606-8501, Japan.;Department of Respiratory Medicine, Graduate School of Medicine, Osaka;Metropolitan University, 1-4-3 Asahimachi, Abeno-ku, Osaka 545-8585, Japan.;Health, Kyoto University, Yoshidakonoe-cho, Sakyo-ku, Kyoto 606-8501, Japan;;Japan Oncology Clinical Sciences Development, Oncology Therapeutic Area Unit,;Takeda Pharmaceutical Company Limited, 4-1-1 Doshomachi, Chuo-ku, Osaka 540-8645,;Japan.;Department of Clinical Medicine, Institute of Medicine, University of Tsukuba,;1-1-1 Tennodai, Tsukuba 305-8575, Japan.;Electronic address: kawakami.koji.4e@kyoto-u.ac.jp. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/42161019/ |
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