Adherence with tobramycin inhaled solution and health care utilization

BMC Pulm Med. 2011 Jan 20;11:5. doi: 10.1186/1471-2466-11-5.

Abstract

Background: Adherence with tobramycin inhalation solution (TIS) during routine cystic fibrosis (CF) care may differ from recommended guidelines and affect health care utilization.

Methods: We analyzed 2001-2006 healthcare claims data from 45 large employers. Study subjects had diagnoses of CF and at least 1 prescription for TIS. We measured adherence as the number of TIS therapy cycles completed during the year and categorized overall adherence as: low ≤ 2 cycles, medium >2 to <4 cycles, and high ≥ 4 cycles per year. Interquartile ranges (IQR) were created for health care utilization and logistic regression analysis of hospitalization risk was conducted by TIS adherence categories.

Results: Among 804 individuals identified with CF and a prescription for TIS, only 7% (n = 54) received ≥ 4 cycles of TIS per year. High adherence with TIS was associated with a decreased risk of hospitalization when compared to individuals receiving ≤ 2 cycles (adjusted odds ratio 0.40; 95% confidence interval 0.19-0.84). High adherence with TIS was also associated with lower outpatient service costs (IQR: $2,159-$8444 vs. $2,410-$14,423) and higher outpatient prescription drug costs (IQR: $35,125-$60,969 vs. $10,353-$46,768).

Conclusions: Use of TIS did not reflect recommended guidelines and may impact other health care utilization.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Cystic Fibrosis / drug therapy*
  • Cystic Fibrosis / economics
  • Female
  • Health Services / economics
  • Health Services / statistics & numerical data*
  • Hospitalization / economics
  • Humans
  • Male
  • Medication Adherence*
  • Pseudomonas Infections / drug therapy*
  • Pseudomonas aeruginosa / isolation & purification*
  • Tobramycin / administration & dosage*
  • Young Adult

Substances

  • Tobramycin