OBJECTIVES: Inhaled corticosteroids (ICS), long-acting beta agonists (LABA), and long-acting muscarinic antagonists (LAMA) combination therapies are standard maintenance treatments for asthma and COPD. As patients’ experiences with these treatments can impact health outcomes and therapy adherence, it is important to understand which treatment attributes patients value most.

METHODS: Five patient focus groups (N=37) were conducted in 2 US cities. Participants consisted of 2 groups of symptomatic asthma patients (N=15; on medium- or high-dose ICS/LABA; mean Asthma Control Questionnaire (ACQ) score=2.0, SD=1.3) and 3 groups of COPD patients (N=22; COPD Assessment Test (CAT) score >10, mean=28.6, SD=6.0) on approved doses of ICS/LABA, LAMA/LABA, or ICS/LABA+LAMA maintenance therapies. Participants were asked to describe important attributes of their maintenance treatment(s) and then rank up to 5 most important treatment attributes. Focus group transcripts were analyzed using qualitative content analysis, and the ranked attribute responses were categorized.

RESULTS: Average age of participants was 52.4 years; most were female (68%), white (59%), and had health insurance through their employer (62%). Treatment effectiveness (eg, decrease in frequency of exacerbations, less need for rescue medication) was the most important attribute for patients in both diseases, but COPD patients included more effectiveness attributes in their rankings than asthma patients. Convenience of use of the inhaler device (eg, number of steps to prime device, easy-to-read dose counter), side effects (eg, weight gain), dosing frequency, cost, and taste (eg, taste of particles from the drug capsule) were also ranked as important attributes. Although most patients (97%) had health insurance, out-of-pocket costs were a concern in both diseases, and some patients reported being non-adherent for cost reasons.

CONCLUSIONS: Although effective symptom management is the key maintenance therapy attribute for asthma and COPD patients, non-clinical attributes such as convenience of use and out-of-pocket costs are also important and can affect treatment adherence.