{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T06:47:49Z","timestamp":1777531669173,"version":"3.51.4"},"reference-count":23,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2012,11,13]],"date-time":"2012-11-13T00:00:00Z","timestamp":1352764800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Chron Respir Dis"],"published-print":{"date-parts":[[2013,2]]},"abstract":"<jats:p>Tiotropium is an innovative intervention in chronic obstructive pulmonary disease (COPD). Early adherence to tiotropium remains inadequately explored, notably time from initiation to discontinuation (persistence). In patients with COPD, the factors associated with the risk of discontinuing the treatment with tiotropium within 12\u00a0months following initiation were identified (12-month persistence). Claim databases from the French Social Security were used. A random sample of patients (aged 50\u201380\u00a0years) who initiated tiotropium soon after launch was selected. Factors associated with the persistence were investigated (Log-rank test and multivariate Cox model). Of the 1147 newly treated patients (mean age 68\u00a0years, 33% women), 64% remained in the treatment of tiotropium for over a period of 12 months following initiation. More than 10% of the patients interrupted therapy after a single dispensing, most often those with mild COPD. Lower risks of discontinuing tiotropium within 12\u00a0months following initiation were observed when it was initiated by a private sector specialist (hazard ratio (HR)\u00a0=\u00a00.65, 95% confidence interval (CI)\u00a0=\u00a0(0.52\u20130.82)), by hospital-based physician (HR\u00a0=\u00a00.58, 95% CI\u00a0=\u00a0 (0.42\u20130.78)), when\u00a0\u2265\u00a02 other respiratory drugs were associated (HR\u00a0=\u00a00.74, 95% CI\u00a0=\u00a0(0.58\u20130.95)) and in case of long-term disease status (HR\u00a0=\u00a00.78, 95% CI\u00a0=\u00a0(0.63\u20130.97)). Conversely, no clear effect appeared according to age or gender. In this population of patients with COPD, fewer early discontinuations of tiotropium were observed in patients having a severe condition.<\/jats:p>","DOI":"10.1177\/1479972312464245","type":"journal-article","created":{"date-parts":[[2012,11,13]],"date-time":"2012-11-13T21:09:12Z","timestamp":1352840952000},"page":"11-18","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":7,"title":["Factors associated with early adherence to tiotropium in chronic obstructive pulmonary disease"],"prefix":"10.1177","volume":"10","author":[{"given":"Laurent","family":"Laforest","sequence":"first","affiliation":[{"name":"Unit\u00e9 de Pharmaco\u00e9pid\u00e9miologie, CHU-Lyon, d\u2019Odontologie - UMR 5558 CNRS - Universit\u00e9 Claude Bernard Lyon, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Idlir","family":"Licaj","sequence":"additional","affiliation":[{"name":"Unit\u00e9 de Pharmaco\u00e9pid\u00e9miologie, CHU-Lyon, d\u2019Odontologie - UMR 5558 CNRS - Universit\u00e9 Claude Bernard Lyon, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gilles","family":"Devouassoux","sequence":"additional","affiliation":[{"name":"Service de pneumologie, H\u00f4pital de la Croix Rousse, Hospices Civils de Lyon, Lyon, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susanne","family":"Hartwig","sequence":"additional","affiliation":[{"name":"Unit\u00e9 de Pharmaco\u00e9pid\u00e9miologie, CHU-Lyon, d\u2019Odontologie - UMR 5558 CNRS - Universit\u00e9 Claude Bernard Lyon, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Serge","family":"Marvalin","sequence":"additional","affiliation":[{"name":"Direction R\u00e9gionale du Service M\u00e9dical Rh\u00f4ne-Alpes, 26, rue d'Aubigny, Lyon, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric","family":"Van Ganse","sequence":"additional","affiliation":[{"name":"Unit\u00e9 de Pharmaco\u00e9pid\u00e9miologie, CHU-Lyon, d\u2019Odontologie - UMR 5558 CNRS - Universit\u00e9 Claude Bernard Lyon, France"},{"name":"Service de pneumologie, H\u00f4pital de la Croix Rousse, Hospices Civils de Lyon, Lyon, France"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2012,11,13]]},"reference":[{"key":"bibr1-1479972312464245","doi-asserted-by":"publisher","DOI":"10.1016\/j.rmr.2009.08.003"},{"key":"bibr2-1479972312464245","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00133805"},{"key":"bibr3-1479972312464245","unstructured":"Global initiative for chronic Obstructive Lung Disease (GOLD). Global Strategy for Diagnosis, Management, and Prevention of COPD. 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