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. 2011 Jan 20:11:5.
doi: 10.1186/1471-2466-11-5.

Adherence with tobramycin inhaled solution and health care utilization

Becky A Briesacher  1 , Alexandra L Quittner, Lisa Saiman, Patricia Sacco, Hassan Fouayzi, Lynne M Quittell
Affiliations

Adherence with tobramycin inhaled solution and health care utilization

Becky A Briesacher et al. BMC Pulm Med. .

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.

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