Relationship between adherence to inhaled corticosteroids and poor outcomes among adults with asthma

Williams, L. Keoki; Pladevall, Manel; Xi, Hugo; Peterson, Edward L.; Joseph, Christine L.M.; Lafata, Jennifer Elston; Ownby, Dennis R.; Johnson, Christine Cole

doi:10.1016/j.jaci.2004.09.028

Cited by 428 publications

(204 citation statements)

References 25 publications

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“…Adherence to ICS is often poor (50%) and is related to poor asthma outcomes. 26 In contrast, we observed high levels of sustained adherence (>80%) to 12 weeks, predominantly in those whom we identified as having BHR. This finding may be due to a combination of the awareness of the dose monitors as well as the process of goal setting and encouragement by the study clinician.…”

Section: Discussioncontrasting

confidence: 62%

Feasibility and acceptability of using bronchial hyperresponsiveness to manage asthma in primary care: a pilot study

Turton

Glasgow

Brannan

2012

Primary Care Respiratory Journal

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Aims: To determine if indirect testing for bronchial hyperresponsiveness (BHR) to monitor inhaled corticosteroid (ICS) treatment in asthma is feasible and acceptable in primary care.Methods: Fourteen adult patients with asthma aged 22-70 years (4M:10F, forced expiratory volume in 1 s >70% predicted) taking ICS performed a test for BHR using mannitol on three visits 6 weeks apart. ICS dose adjustments were made based on the presence of BHR. The Asthma Quality of Life Questionnaire (AQLQ) and the Asthma Control Questionnaire were used at each visit. A semi structured interview at study exit assessed subject acceptability.Results: BHR did not return in those with no BHR at study entry (n=9) with decreasing ICS dose. Improvements in BHR with increasing ICS dose (n=5) were observed with clinically significant improvements in AQLQ (mean score increase >0.5, p=0.02). Feasibility and acceptability of BHR testing was demonstrated.Conclusions: It is feasible and acceptable to perform BHR testing using mannitol to help identify patients with asthma who would benefit from ICS dose increases and those with no BHR who could have a dose reduction.

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Section: Discussioncontrasting

confidence: 62%

Feasibility and acceptability of using bronchial hyperresponsiveness to manage asthma in primary care: a pilot study

Turton

Glasgow

Brannan

2012

Primary Care Respiratory Journal

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“…Williams et al 5) found that adherence to ICS was negatively correlated with the number of emergency department visits. Poor adherence to ICS therefore appears to account for the majority of asthma-related hospitalizations.…”

Section: Introductionmentioning

confidence: 99%

Influence of Patients' Adherence to Medication, Patient Background and Physicians' Compliance to the Guidelines on Asthma Control

et al. 2011

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This study conducted a thorough examination on the associations among several factors of asthma therapy, i.e., physicians' compliance with the guidelines, patients' adherence to medication, asthma symptom severity, asthma episodes, and patient background. Fifty outpatients treated continuously for asthma from October 2002 to October 2004 at Showa University Hospital were selected and their medical charts were surveyed. Physicians were recognized as noncompliant when their treatments included divergence from the Asthma Prevention and Management Guidelines. Patient adherence was evaluated as the ratio of the``measured (dispensed)'' doses divided by the``expected (prescribed)'' doses. The inhaled corticosteroids adherence and the ratio of the asthma-related emergency department visits of the patients with a family asthma medical history were signiˆcantly higher ( p＝0.034) and lower (p＝0.043), respectively, than those without this medical history. This may indicate the necessity of education for patients with no family history of asthma. A signiˆcant correlation between the mean patients' adherence and the asthma symptom severity at the end of surveillance was found ( p＝0.010), suggesting the importance of patient adherence in asthma control. The asthma symptom severity in the noncompliant group at the beginning of surveillance was signiˆcantly worse ( p＝0.016), suggesting that physician compliance was low when the asthma symptom severity was poor. Based on the aboveˆndings, we proposed a ‰ow-chart, which includes the conˆrmation processes of patients' adherence to medication and physicians' compliance to guidelines, in order to better control asthma, while also taking their family medical history into account.

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“…1 Regular long-term use of ICS has been shown to prevent hospitalisations for asthma, 4 while suboptimal adherence to ICS has been linked to poor asthma control. [5][6][7][8] Nonetheless, suboptimal adherence to prescribed controller therapy is common among both adults and children. [9][10][11][12][13][14] Long-term studies indicate that adherence to asthma controller therapy decreases over time, 15,16 and persistence with therapy may be poor.…”

Section: Introductionmentioning

confidence: 99%

Suboptimal persistence with inhaled corticosteroid monotherapy among children with persistent asthma in the UK

Zhang

Taylor

Sazonov

et al. 2010

Primary Care Respiratory Journal

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Relationship between adherence to inhaled corticosteroids and poor outcomes among adults with asthma

Cited by 428 publications

References 25 publications

Feasibility and acceptability of using bronchial hyperresponsiveness to manage asthma in primary care: a pilot study

Feasibility and acceptability of using bronchial hyperresponsiveness to manage asthma in primary care: a pilot study

Influence of Patients' Adherence to Medication, Patient Background and Physicians' Compliance to the Guidelines on Asthma Control

Suboptimal persistence with inhaled corticosteroid monotherapy among children with persistent asthma in the UK

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