The effects of patient education programs on medication use among asthma and COPD patients: a propensity score matching with a difference-in-difference regression approach

Nazmi Sari, Meric Osman

Adherence to medication is one of the critical determinants of successful management of chronic diseases including asthma and chronic obstructive pulmonary disease (COPD). Given that poor adherence with self-management medication is very common among asthma and COPD patients, interventions that improve the use of chronic disease management medications for this patient group have potential to generate positive health outcomes. In an effort to improve asthma and COPD care, the Lung Association of Saskatchewan has implemented an intervention by providing access to effective and high quality asthma and COPD education for both patients and health care professionals along with increasing access to spirometry. By evaluating the impacts of this intervention, our purpose in this paper is to examine the effectiveness of spirometry use, and asthma and COPD education in primary care setting on medication use among asthma and COPD patients. At the time of the intervention, the Lung Association of Saskatchewan has not assigned a control group. Therefore we used a propensity score matching to create a control group using administrative health databases spanning 6 years prior to the intervention. Using Saskatchewan administrative health databases, the impacts of the intervention on use of asthma and COPD medications were estimated for one to four years after the intervention using a difference in difference regression approach. The paper shows that overall medication use for the intervention group is higher than that of the control group. On average, intervention group uses more asthma and COPD drugs. Within the asthma and COPD drugs, this intervention creates a persistent effect over time in the form of higher utilization of chronic management drugs equivalent to $157 and $195 in a given year during four years after the intervention. The study suggests that effective patient education and increasing access to spirometry increases the utilization of chronic disease management drugs among asthma and COPD patients. This type of interventions with patient education focus has potential to save healthcare dollars by providing better disease management among this patient group.