Medication adherence in asthma patients

Sumino, Kaharu; Cabana, Michael D.

doi:10.1097/mcp.0b013e32835b117a

Cited by 65 publications

(39 citation statements)

References 31 publications

(19 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Respiratory allergy and other chronic diseases have similar medication treatment discontinuation rates [9]. Table 1 summarizes data about adherence to treatment for common chronic diseases [10][11][12][13][14][15][16].…”

Section: Introductionmentioning

confidence: 99%

Allergen Immunotherapy Adherence in the Real World: How Bad Is It and How Can It Be Improved?

Senna

Caminati

Lockey

2014

Curr Treat Options Allergy

View full text Add to dashboard Cite

Opinion StatementAllergen immunotherapy (AIT) is the only available causal treatment for allergic respiratory diseases; however, data demonstrate a high discontinuation rate for both subcutaneous immunotherapy (SCIT) and sublingual immunotherapy (SLIT). The complex mechanism of action of allergen immunotherapy (AIT) includes an interaction of innate and adaptive immune processes, resulting in immune tolerance, as illustrated by a decrease in specific immunoglobulin (Ig)-E, an increase in specific IgG1 and IgG4, and inhibition of inflammation involving mast cells, basophils, and eosinophils. This induction of immune tolerance leads to a significant improvement in symptoms and decreased medication scores. A 3-to 5-year course of AIT is required to obtain this disease-modifying effect, which substantially differentiates AIT frompharmacologic treatment. A carry-over effect can persist for up to 12 years. Furthermore, AIT may prevent the onset of asthma in patients with allergic rhinitis, as well as decreasing the onset of new sensitizations to inhalant allergens. Several meta-analyses and controlled studies, involving adult and pediatric subjects, have indicated that both sublingual immunotherapy (SLIT) and subcutaneous immunotherapy (SCIT) are relatively safe, effective, and well tolerated. AIT may also have a positive impact on the cost to the healthcare system, as evidence indicates the cost-benefit of such treatment. Adherence to AIT is crucial for a positive clinical outcome and non-adherence represents a major drawback for such therapy. It actually concerns not only AIT but also various pharmacologic treatments for allergic respiratory diseases, as well as for other chronic illnesses. The issue of non-adherence is an emerging and worldwide problem for chronic diseases and could be an important factor responsible for an overall decrease in treatment efficacy and increased rates of hospitalization, morbidity, and mortality. This review provides an overview of the different reasons that may account for the low adherence rate for AIT. Some of these reasons can be related to the patient's age when they begin such therapy, the allergic disease being treated, and questions about the efficacy, costs, inconvenience, and safety of AIT. Well-structured educational programs,especially by healthcare professionals, the print media, and the Internet, are needed to improve adherence to AIT.

show abstract

Section: Introductionmentioning

confidence: 99%

Allergen Immunotherapy Adherence in the Real World: How Bad Is It and How Can It Be Improved?

Senna

Caminati

Lockey

2014

Curr Treat Options Allergy

View full text Add to dashboard Cite

show abstract

“…In this case, an objective adherence evaluation may rely on different tools but due to many limitations with these tools their use in routine clinical practice is not suitable. Electronic devices are accurate but are also quite expensive [13]; therefore recording of pharmacy refills can be considered as a more affordable option but they are less accurate. Patients usually deny any lack of adherence, even in severe asthma [14].…”

Section: Introductionmentioning

confidence: 99%

Drop-out rate among patients treated with omalizumab for severe asthma: Literature review and real-life experience

et al. 2016

View full text Add to dashboard Cite

BackgroundIn patients with asthma, particularly severe asthma, poor adherence to inhaled drugs negatively affects the achievement of disease control. A better adherence rate is expected in the case of injected drugs, such as omalizumab, as they are administered only in a hospital setting. However, adherence to omalizumab has never been systematically investigated. The aim of this study was to review the omalizumab drop-out rate in randomized controlled trials (RCTs) and real-life studies. A comparative analysis was performed between published data and the Italian North East Omalizumab Network (NEONet) database.ResultsIn RCTs the drop-out rate ranged from 7.1 to 19.4 %. Although the reasons for withdrawal were only occasionally reported, patient decision and adverse events were the most frequently reported causes. In real-life studies the drop-out rate ranged from 0 to 45.5 %. In most cases lack of efficacy was responsible for treatment discontinuation. According to NEONet data, 32 % of treated patients dropped out, with an increasing number of drop outs observed over time. Patient decision and lack of efficacy accounted for most treatment withdrawals.ConclusionsTreatment adherence is particularly crucial in patients with severe asthma considering the clinical impact of the disease and the cost of non-adherence. The risk of treatment discontinuation has to be carefully considered both in the experimental and real-life settings. Increased knowledge regarding the main reasons for patient withdrawal is important to improve adherence in clinical practice.

show abstract

“…este resultado contraintuitivo podría explicarse por el uso inadecuado del inhalador, la mala calidad de la droga utilizada o el dato no fidedigno entregado por los pacientes. esto último no se puede descartar a priori ya que la mayoría de los estudios tanto nacionales 44 como extranjeros 45 , muestran la baja adherencia al tratamiento. otra explicación podría ser la existencia de sesgo por indicación, manifestado por el hecho que pacientes con mal control del asma en la visita inmediatamente anterior, se les podría haber prescrito o corregido el uso de corticoides, no logrando aún el control sintomático en la visita incluida en el presente evaluaCión del Grado de ConTrol del asMa en un CenTro de aTenCión PriMaria estudio.…”

Section: Resultsunclassified

Evaluación del grado de control del asma en un centro de atención primaria: Un estudio descriptivo

T¹,

R²,

G³

et al. 2016

Rev. chil. enferm. respir.

View full text Add to dashboard Cite

Assessment of the degree of asthma control in a primary care center Achieve a good clinical control by reducing symptoms and management of modifiable risk factors for exacerbations is the main goal of asthma treatment. Our objective was to assess the degree of clini-tRAbAjo oRiginAl introducción el objetivo actual del tratamiento del asma consiste en alcanzar y mantener el control clínico de la enfermedad 1 , el que se compone de dos dominios: a) el control de síntomas y limitaciones del paciente y b) el manejo de los riesgos de mala evolución futura, que incluye las exacerbaciones, el desarrollo de obstrucción fija al flujo de aire y las reacciones adversas a los medicamentos 2 . el nivel de control se refiere al estado actual de la enfermedad, el que puede variar marcadamente en períodos cortos de tiempo y refleja más directamente la efectividad de las intervenciones terapéuticas 3 . Como tanto los pacientes como los médicos tratantes generalmente sobrestiman el grado de control de la enfermedad 4 , se han desarrollado una serie de herramientas simples de aplicar en la práctica diaria para identificar a los pacientes con asma mal controlada. las más utilizadas son los cuestionarios de GINA, el aCQ (Asthma Control Questionnaire) y el aCT (Asthma Control Test) 5 . en cuanto a la reducción de los riesgos futuros, el riesgo de desarrollar exacerbaciones es el más importante debido su asociación con mayor

show abstract

Medication adherence in asthma patients

Abstract: There is an urgent clinical need for systematic, proven methods to assess and address medication nonadherence in asthma patients.

Cited by 65 publications

References 31 publications

Allergen Immunotherapy Adherence in the Real World: How Bad Is It and How Can It Be Improved?

Allergen Immunotherapy Adherence in the Real World: How Bad Is It and How Can It Be Improved?

Drop-out rate among patients treated with omalizumab for severe asthma: Literature review and real-life experience

Evaluación del grado de control del asma en un centro de atención primaria: Un estudio descriptivo

Contact Info

Product

Resources

About