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Characteristics of patients preferring once-daily controller therapy for asthma and COPD: a retrospective cohort study

Primary Care Respiratory Journal volume 22, pages 161168 (2013) | Download Citation




Patient preference is an important factor when choosing an inhaler device for asthma or chronic obstructive pulmonary disease (COPD).


To identify characteristics of patients with asthma or COPD who prefer a once-daily controller medication regimen.


This retrospective observational study used electronic patient records and linked outcomes from patient-completed questionnaires in a primary care database. We compared the characteristics of patients indicating a preference for once-daily therapy with those who were unsure or indicating no preference.


Of 3,731 patients with asthma, 2,174 (58%) were women; the mean age was 46 years (range 2–94). Of 2,138 patients with COPD, 980 (46%) were women; the mean age was 70 years (range 35–98). Approximately half of the patients in each cohort indicated once-daily preference, one-quarter were unsure, and one-quarter did not prefer once-daily therapy. In patients with asthma or COPD, the preference for once-daily controller medication was significantly associated with poor adherence and higher concerns about medication. In asthma, good control and low self-perceived controller medication need were associated with once-daily preference. By contrast, in COPD, a high self-perceived need for controller medication was associated with once-daily preference. There was no significant relationship between once-daily preference and age, sex, disease severity, or exacerbation history.


Understanding patient preferences may help prescribers to individualise therapy better for asthma and COPD.

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Handling editor Maureen George

Statistical review Gopal Netuveli

We thank Annie Burden for her help with statistical analyses and Rob Horne for his input on the study design and analyses.

Funding The study was sponsored by GlaxoSmithKline. The funders had no role in the conduct of the study or interpretation of study results.

Author information


  1. Academic Centre of Primary Care, University of Aberdeen, UK

    • David Price
  2. Research in Real Life, Cambridge, UK

    • David Price
    • , Erika J Sims
    • , Linda Kemp
    • , Elizabeth V Hillyer
    • , Alison Chisholm
    •  & Julie von Ziegenweidt
  3. Division of Applied Health Sciences, University of Aberdeen, UK

    • Amanda J Lee
  4. Norwich Medical School, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK

    • Erika J Sims
  5. GlaxoSmithKline R&D, Uxbridge, UK

    • Angela Williams
  6. MedImmune, Cambridge, UK

    • Angela Williams


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DP, EJS, and AW conceived and designed the study. LK conducted the analyses, with help from JvZ and AJL. EVH wrote the initial draft of the paper. All authors contributed to the interpretation of the data, writing of the manuscript, and review of the final draft. DP is the study guarantor.

Competing interests

DP has consultant arrangements with Almirral, AstraZeneca, Boehringer Ingelheim, Chiesi, GlaxoSmithKline, Merck, Mundipharma, Medapharma, Novartis, Napp, Nycomed, Pfizer, Sandoz, and Teva. He or his research team have received grants and support for research in respiratory disease from the following organisations in the last 5 years: UK National Health Service, Aerocrine, AstraZeneca, Boehringer Ingelheim, Chiesi, GlaxoSmithKline, Merck, Mundipharma, Novartis, Nycomed, Orion, Pfizer, and Teva. He has spoken for Almirral, AstraZeneca, Activaero, Boehringer Ingelheim, Chiesi, Cipla, GlaxoSmithKline, Kyorin, Novartis, Merck, Mundipharma, Pfizer, and Teva. He has shares in AKL Ltd which produces phytopharmaceuticals. He is the sole owner of Research in Real Life Ltd and its subsidiary social enterprise Optimum Patient Care. AJL receives ad hoc payment for statistical consultancy with RIRL. EJS and JvZ are employees of RiRL. EVH is a consultant to RiRL and has done freelance writing work for Merck, Aerocrine, and TevaFrance. At the time this study was conducted, LK and AC were employees of RiRL and AW was an employee of GSK R&D.

Corresponding author

Correspondence to David Price.


Appendix. STROBE Statement—Checklist for cohort studies — Price D, et al. Characteristics of patients preferring once-daily controller therapy for asthma and chronic obstructive pulmonary disease: retrospective observational study

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