Direct clinician-to-patient feedback discussion of inhaled steroid use: its effect on adherence

Onyirimba, Faustinus; Apter, Andrea J.; Reisine, Susan; Litt, Mark D.; McCusker, Corliss; Connors, MaryLou; ZuWallack, Richard

doi:10.1016/s1081-1206(10)61825-x

Cited by 102 publications

(87 citation statements)

References 11 publications

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“…Similar results were found by Corsico et al in European Community Respiratory Health Survey study of 971 subjects with asthma 21 . In fact, it has been demonstrated that regular follow up consultations with clinicians reinforce the partnership between patients and healthcare workers with a subsequent positive effect on the medication adherence [22][23][24] .…”

Section: Discussionmentioning

confidence: 99%

Evaluation of factors affecting adherence to asthma controller therapy in chest clinics in a sub-Saharan African setting: a cross-sectional study

et al. 2016

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Abstract:Background: Adherence to controller therapy in asthma is a major concern during the management of the disease. Objective: To determine the adherence rate and identify the predictors of low adherence to asthma controller therapy. Methods: A cross-sectional study including asthma patients was conducted from November 1, 2012 to May 31, 2013 in 4 chest clinics in Cameroon. The adherence to asthma treatment was rated using Morisky Medication Adherence Scale. A multivariate logistic regression analysis was performed for the identification of factors associated with adherence to asthma treatment. Results: Among the 201 asthma patients included, 133 (66.2%) were female. The mean age of participants was 41.2 years. Sixty-one (30.3%) of the patients did not visit the chest physician during the last year prior to the study. Asthma was well controlled in 118 patients (58.7%). The prevalence of low adherence rate to asthma controller therapy was 44.8% and the absence of any chest specialist visit within the last 12 months was the only factor associated with the low adherence rate to asthma treatment (OR 5.57 ; 95% CI 2.84-10.93). Conclusion:The adherence rate to asthma controller therapy in Cameroon is low and it could be improved if scheduled visits are respected by patients.

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Section: Discussionmentioning

confidence: 99%

Evaluation of factors affecting adherence to asthma controller therapy in chest clinics in a sub-Saharan African setting: a cross-sectional study

et al. 2016

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“…Using results from a previous 10-week study that tested an adherence intervention among patients with asthma, 20 power and sample size calculations indicated that 25 participants in each group would provide 75% power to detect a group difference of 36%.…”

Section: Design and Sample Sizementioning

confidence: 99%

Test of an Interactive Voice Response Intervention to Improve Adherence to Controller Medications in Adults with Asthma

Bender¹,

Apter²,

Bogen³

et al. 2010

The Journal of the American Board of Family Medicine

109

130

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Objective: This study was conducted to test the effectiveness of a theory-based interactive voice response (IVR) intervention to improve adherence to controller medications among adults with asthma.Methods: Fifty participants aged 18 to 65 years who had a physician diagnosis of asthma and a prescription for a daily inhaled corticosteroid, attended a baseline visit and a final visit 10 weeks later. Participants randomized to the intervention group received 2 automated IVR telephone calls separated by one month, with one additional call if they reported recent symptoms of poorly controlled disease or failure to fill a prescription. Calls were completed in less than 5 minutes and included content designed to inquire about asthma symptoms, deliver core educational messages, encourage refilling of inhaled corticosteroid prescriptions, and increase communication with providers. Adherence was tracked during 10 weeks, with objective measures that included either electronic monitors or calculation of canister weight. Participants completed the Asthma Quality of Life Questionnaire, the Asthma Control Test, and the Beliefs in Medications Questionnaire (BMQ) during both visits.Results: Adherence was 32% higher among patients in the IVR group than those in the control group (P ‫؍‬ . Patients often do not adhere to treatments for chronic health conditions, with the consequence that many conditions are poorly controlled. In the treatment of asthma, fewer than half of prescribed daily controller medication is typically taken by patients.1,2 In a report about refill patterns among 5500 patients with asthma, only 43% filled their inhaled corticosteroid more than once during 12 months. 3 In another study, each 25% decrease in refilled medication was accompanied by a doubling of the hospitalization rate. 2 Adherence rates among children are similarly poor 4,5 and remain so even in the face of recent exacerbation. 6 Considerable attention has been directed at changing health behavior and increasing adherence to treatments for chronic health conditions. The World Health Organization in 2003 published a call for action to improve treatment adherence across diseases, continents, and cultures, 7 and the This article was externally peer reviewed.

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“…The study relies on surrogate markers of compliance, rather than direct measures. Moreover, the analysis does not disentangle other factors employed by physicians in general practice that might influence compliance, such as clinical feedback [3] or motivational models [20]. Neither does the study consider the impact of different devices available for delivering the ICS dose.…”

Section: Study Limitationsmentioning

confidence: 99%

“…However, it has been estimated previously that only 40% of asthma patients are compliant with their medication over five weeks; half the patients in one study underused their medication and 10% overused their inhaler [2]. In another study, compliance declined from 51% during the first week of treatment to less than 30% after 10 weeks [3]. Non-compliance does not always lead to disease exacerbation.…”

Section: Introductionmentioning

confidence: 99%

Switching asthma patients to a once-daily inhaled steroid improves compliance and reduces healthcare costs

Guest

Davie

Ruiz

et al. 2005

Primary Care Respiratory Journal

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Objective: To determine the costs and consequences of switching asthma patients, managed in primary care, from a twice-daily inhaled corticosteroid (ICS), to either a once-daily or another twice-daily ICS. Design: This was a case-control study based on an interrogation of the General Practice Research Database in the UK, for patients with a Read code of asthma who were managed between 1990 and 2001, and who had received at least two prescriptions for a twice-daily ICS within 12 months, before switching to a once-daily ICS (cases) or another twice-daily ICS (controls). Data on resource use was collected for one year before and after the switch. Patients were stratified according to whether their treatment step had been stepped up, stepped down or remained unchanged. Setting: A modelling study performed from the perspective of the UK's National Health Service (NHS). Main outcome measures: Compliance with ICS, and the cost of drug and non-drug resource use, for the year before and after the switch. Results: Switching patients managed in primary care to a once-daily ICS increased compliance and reduced NHS costs, irrespective of whether patients' treatment had been stepped up or down. Switching patients to another twice-daily ICS increased compliance to a lesser extent, and increased NHS costs. We believe that this paper offers the first documented association between compliance in asthma and NHS management costs. Conclusions: Compliance and management costs among patients with asthma managed in primary care appear to be related to both changing treatment and dosing regimen. Within the limitations of our study, the results suggest that patients who are switched to a once-daily ICS rather than another twice-daily preparation are better compliers with their ICS medication. Additionally, patients who become high-* Corresponding author. C o p y r ig h t G e n e r a l P r a c t ic e A ir w a y s G r o u p R e p r o d u c t io n p r o h ib it e dCosts and compliance associated with once-daily inhaled steroids 89 compliers after being switched to a once-daily ICS incur lower management costs than patients who become high-compliers after being switched to another twice-daily ICS. These findings should now be investigated further under more controlled conditions.

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Direct clinician-to-patient feedback discussion of inhaled steroid use: its effect on adherence

Cited by 102 publications

References 11 publications

Evaluation of factors affecting adherence to asthma controller therapy in chest clinics in a sub-Saharan African setting: a cross-sectional study

Evaluation of factors affecting adherence to asthma controller therapy in chest clinics in a sub-Saharan African setting: a cross-sectional study

Test of an Interactive Voice Response Intervention to Improve Adherence to Controller Medications in Adults with Asthma

Switching asthma patients to a once-daily inhaled steroid improves compliance and reduces healthcare costs

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