Persistence with inhaled corticosteroid therapy in daily practice

Breekveldt-Postma, Nancy S; Gerrits, Charles; Lammers, Jan-Willem; Raaijmakers, J. A. M.; Herings, Ron M. C.

doi:10.1016/j.rmed.2004.01.014

Cited by 53 publications

(59 citation statements)

References 27 publications

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“…In adult patients with mild asthma not using inhaled corticosteroids, a mean FeNO of 49 ppb has been reported [19]. In a 4-week study in patients with mild persistent asthma, regular treatment with budesonide Turbuhaler1 100 mg?day -1 resulted in a decrease in exhaled NO from 29 to 21 ppb and with 400 mg?day -1 from 32 to 16 ppb, while placebo left levels unchanged [30]. Consequently, the reduction in FeNO with as-needed budesonide/ formoterol in the present study (-18.2 ppb) appears to be in the range obtained with regular use of inhaled corticosteroids.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Formoterol as needed with or without budesonide in patients with intermittent asthma and raised NO levels in exhaled air: a SOMA study

Haahtela

Tamminen²,

Malmberg³

et al. 2006

European Respiratory Journal

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Patients with mild intermittent asthma sometimes show signs of inflammation, and guidelines suggesting bronchodilator therapy alone as needed may be questioned.The current study compared as-needed use of a rapid-acting b 2 -agonist with as-needed use of a b 2 -agonist and corticosteroid combination as the only medication in asthma patients with intermittent symptoms. A total of 92 nonsmoking asthma patients (of 187 screened) using only an inhaled b 2 -agonist as needed (28 males, 64 females; mean age 37 yrs; mean forced expiratory volume in one second (FEV1) 101% predicted, mean reversibility 6.5% pred and fractional exhaled nitric oxide (FeNO) o20 parts per billion (ppb)) were randomised to treatment with formoterol (Oxis1 Turbuhaler1) 4.5 mg as needed (n547) or budesonide/formoterol (Symbicort1 Turbuhaler1) 160/4.5 mg as needed (n545) in a double-blind, parallel-group 24-week study.The primary variable of efficacy was change in FeNO. Baseline FeNO was 60 ppb and 59 ppb in the budesonide/formoterol and formoterol groups, respectively. Mean reductions in FeNO in the budesonide/formoterol and formoterol groups were 18.2 ppb and 2.8 ppb, respectively (95% confidence interval (CI) 7.5-23.5 ppb). The reduction in the budesonide/formoterol group occurred during the first 4 weeks of treatment and remained at this low level. Mean FEV1 increased by 1.8% pred normal value in the budesonide/formoterol group and decreased by 0.9% pred normal value in the formoterol group (95% CI -4.7--0.7). In the budesonide/formoterol group, use of o4 inhalations?day -1 of study medication was seen on 21 treatment days compared with 74 in the formoterol group.In conclusion, as-needed use of an inhaled corticosteroid together with a rapid-acting bronchodilator may be more beneficial than a b 2 -agonist alone in patients with intermittent asthma and signs of airway inflammation. The long-term benefits are unknown.

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Section: Discussionmentioning

confidence: 99%

“…Even patients with mild persistent asthma seldom adhere to regular prophylactic medication. If prescribed an inhaled corticosteroid for maintenance treatment, many patients tend to discontinue that treatment within weeks or months if they become symptom free [30].…”

Section: Discussionmentioning

confidence: 99%

Formoterol as needed with or without budesonide in patients with intermittent asthma and raised NO levels in exhaled air: a SOMA study

Haahtela

Tamminen²,

Malmberg³

et al. 2006

European Respiratory Journal

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“…For over a decade, the core pharmacological management of asthma has focused on preventer therapy with ICS [3]. Despite the importance of the regular use of ICS, low adherence rates have repeatedly been reported across studies, with ICS adherence ranging from 40% to 60% [4][5][6][7].…”

Section: Introductionmentioning

confidence: 99%

Beliefs about medicines predict refill adherence to inhaled corticosteroids

Menckeberg

Bouvy

Bracke

et al. 2008

Journal of Psychosomatic Research

305

272

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“…These include factors related to the characteristics of the patient, the disease, the therapies and also the doctor-patient relationship [14,15,16]. Factors influencing the medication adherence of COPD patients have not been thoroughly investigated [16,17,18]. It is necessary to identify factors related to adherence in order to develop more effective strategies that can improve medication-taking behaviour.…”

Section: Introductionmentioning

confidence: 99%

Factors Associated with Medication Adherence in Patients with Chronic Obstructive Pulmonary Disease

Ágh¹,

Inotai²,

Mészáros³

2011

Respiration

121

110

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Background: Predictors of medication adherence are not well known in chronic obstructive pulmonary disease (COPD). It is therefore necessary to identify factors associated with adherence to improve the effectiveness of COPD management within real-world situations. Objectives: The goals of this study were to estimate adherence to respiratory medication and to identify factors related to adherence in COPD patients. Methods: This was an observational, cross-sectional study conducted on a sample of COPD outpatients. The following information was obtained: adherence to respiratory therapy (Morisky Medication Adherence Scale), age, gender, smoking status, COPD severity [Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage], lung function [post-bronchodilator forced expiratory volume in 1 s (FEV₁)], treatment regimen for COPD, COPD medication costs per month paid by the patient and health-related quality of life (EuroQol 5-dimension questionnaire). A multivariate logistic regression analysis was performed to identify the independent predictors of adherence. Results: Of the 170 participants (mean age 63.8 years, 41.8% male), 58.2% reported optimal adherence. Adherence to respiratory therapy was associated with age, current smoking status, number of respiratory drugs, number of daily respiratory drug doses and quality of life (p < 0.005). Adherence to respiratory therapy was not related to gender, GOLD stage, FEV₁ or COPD medication costs. Conclusions: Adherence to COPD medication regimens is poor. Less frequent dosing regimens could be an effective method to enhance adherence to respiratory therapy. Quality-of-life monitoring within clinical practice settings could facilitate improved medication adherence.

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Persistence with inhaled corticosteroid therapy in daily practice

Abstract: The persistence rate of ICS is poor. Preventing early treatment discontinuation may be important to ensure maximal benefit from ICS treatment.

Cited by 53 publications

References 27 publications

Formoterol as needed with or without budesonide in patients with intermittent asthma and raised NO levels in exhaled air: a SOMA study

Formoterol as needed with or without budesonide in patients with intermittent asthma and raised NO levels in exhaled air: a SOMA study

Beliefs about medicines predict refill adherence to inhaled corticosteroids

Factors Associated with Medication Adherence in Patients with Chronic Obstructive Pulmonary Disease

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