Compliance of patients with asthma with an experimental aerosolized medication: Implications for controlled clinical trials

Spector, Sheldon L.; Kinsman, Robert A.; Mawhinney, Helen; Siegel, Sheldon C.; Rachelefsky, Gary S.; Katz, Roger M.; Rohr, Albert S.

doi:10.1016/0091-6749(86)90325-8

Cited by 179 publications

(69 citation statements)

References 8 publications

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“…18 Although guidelines support the use of ␤ 2 agonists to minimize or prevent symptoms of asthma, asthma patients may not adhere to their prescribed medication treatment. 19 Our study revealed that 25% (14 of 56) of the athletes who indicated a history of asthma or EIB did not report taking any asthma medication. More work is needed to educate the sports community and determine the barriers for the adverse effects, abuse, and non-use of asthma medications in athletes.…”

Section: Discussionmentioning

confidence: 95%

Perception of Exercise-Induced Bronchoconstriction in College Athletes

et al. 2016

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BACKGROUND: Exercise-induced bronchoconstriction (EIB) can lead to long-term respiratory illness and even death. EIB prevalence rates are both high and variable in college athletes. Also, prevalence rates may be underestimated due to ineffective screening. The purpose of this study is to investigate the prevalence of EIB and the perceived impact of EIB in college athletes via a self-report questionnaire. METHODS: A self-report EIB questionnaire was administered to college athletes on 8 different sports teams. Information collected was used to identify athletes who selfreported: (1) a history of EIB and/or asthma, (2) respiratory symptoms during exercise, (3) medication use, and (4) concern about EIB. RESULTS: Results showed that 56 of 196 athletes (28.6%) self-reported a history of EIB or asthma. Over half (52%) reported a history of EIB/asthma or current EIB symptoms. Forty-six of the 140 athletes (32.9%) who did not report a history of EIB or asthma indicated symptoms of EIB during sports, training, or exercise. Fourteen of 56 athletes (25%) self-reporting a history of EIB or asthma did not report the use of a respiratory medication. Nineteen of 196 athletes (9.7%) reported being concerned that EIB was adversely affecting their sports performance. CONCLUSIONS: College athletes self-report a high prevalence of EIB or asthma. Although college athletes may not report a history of EIB or asthma, they indicate symptoms of EIB. A majority of athletes reported a history or current symptoms related to EIB or asthma. Many athletes with a history of EIB or asthma are not taking any asthma medication. Last, athletes report concern about EIB adversely affecting their sports performance. More work is needed using a combination of a screening questionnaire and standardized EIB testing to develop a validated tool for accurately screening and diagnosing EIB in college athletes.

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Section: Discussionmentioning

confidence: 95%

Perception of Exercise-Induced Bronchoconstriction in College Athletes

et al. 2016

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“…The grip turn data correlated well with the TIC data but when compared with the TICs known to be working accurately, grip turns consistently gave a higher level of compliance. This overestimation may be due to patients double-clicking the Turbuhaler before each dose, or dumping doses prior to clinic visits [8,9,14].…”

Section: Methods Of Tic Data Analysismentioning

confidence: 99%

Patient compliance with inhaled medication: does combining beta-agonists with corticosteroids improve compliance?

Bosley

Parry²,

Cochrane³

1994

Eur Respir J

109

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P Pa at ti ie en nt t c co om mp pl li ia an nc ce e w wi it th h i in nh ha al le ed d m me ed di ic ca at ti io on n: : D Do oe es s c co om mb bi in ni in ng g b be et ta a--a ag go on ni is st ts s w wi it th h c co or rt ti ic co os st te er ro oi id ds s i im mp pr ro ov ve e c co om mp pl li ia an nc ce e? ? In an open, multicentre, parallel group study 102 asthmatic patients were randomly divided into two groups, either receiving the two drugs in separate Turbuhalers or combined into one Turbuhaler. A twice daily regimen was prescribed and a preweighed metered-dose inhaler (MDI) of salbutamol was provided for rescue use. Compliance was measured using the Turbuhaler Inhalation Computer (TIC), which recorded the time and date of each inhalation over a 12 week period. Forced expiratory volume in one second (FEV 1 ) and forced vital capacity (FVC) measurements were carried out at week 0, 6 and 12.Results from 72 patients were analysed. The average compliance was 60-70%. Treatment was taken as prescribed on 30-40% of the study days, and over-usage occurred on less than 10% of days. Only 15% of patients took the drugs as prescribed for more than 80% of the days.Compliance was no greater in patients using the combined inhalers. Other ways of improving patient self-management need further investigation.

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“…20 Although guidelines support the use of ␤ 2 agonists to minimize or prevent symptoms of asthma, patients with asthma may not adhere to their prescribed medication treatment. 21 These findings may be related to a number of issues, including the lack of (1) awareness about EIB among sports teams and personnel, (2) education for athletes and parents, and (3) accurate screening and diagnosis of athletes. More work is needed to determine the barriers for the non-use of asthma medications in athletes.…”

Section: Prevalence and Respiratory Medicationmentioning

confidence: 99%

Prevalence of Exercise-Induced Bronchoconstriction Measured by Standardized Testing in Healthy College Athletes

et al. 2016

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BACKGROUND: Exercise-induced bronchoconstriction (EIB) can lead to long-term respiratory illness and even death. EIB prevalence rates are both high and variable in college athletes. Prevalence rates may be underestimated due to ineffective testing and screening. The purpose of this study was to investigate the prevalence of EIB in college athletes by a standardized EIB test that can be used on many college campuses. In addition, we assessed the usefulness of self-reporting EIB/asthma (1) history, (2) symptoms, and (3) respiratory medication obtained from a simple screening questionnaire for predicting an EIB-positive athlete. METHODS: A standardized EIB test and self-report questionnaire were administered to college athletes on 10 different sports teams. Information collected included pulmonary function (spirometry), expired gas analysis (maximal oxygen uptake), CO 2 production, minute ventilation, EIB/asthma history, current symptoms, and medication use. RESULTS: Results showed that 34 of 80 athletes (42.5%) were EIB-positive by standardized exercise testing. The majority (76.5 and 58.8%) of the 34 athletes who tested positive self-reported a negative history or no symptoms, respectively. Also, 79.4% of the athletes who tested positive for EIB reported not using a respiratory medication. There were no significant differences in a positive EIB test when assessing interactions for history (P ‫؍‬ .93), current symptoms (P ‫؍‬ .12), or respiratory medication use (P ‫؍‬ .66). CONCLUSIONS: A high proportion of college athletes tested positive for EIB when using a standardized test. Positive history, current symptoms of EIB/asthma, and respiratory medication use were not predictive of a positive test. Many EIB-positive athletes are not using a respiratory medication. More work is needed to develop an effective screening tool and improve education for EIB in college athletes.

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Compliance of patients with asthma with an experimental aerosolized medication: Implications for controlled clinical trials

Cited by 179 publications

References 8 publications

Perception of Exercise-Induced Bronchoconstriction in College Athletes

Perception of Exercise-Induced Bronchoconstriction in College Athletes

Patient compliance with inhaled medication: does combining beta-agonists with corticosteroids improve compliance?

Prevalence of Exercise-Induced Bronchoconstriction Measured by Standardized Testing in Healthy College Athletes

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