Towards tailored and targeted adherence assessment to optimise asthma management

Boven, Job F M van; Trappenburg, Jaap C.A.; Molen, Thys van der; Chavannes, Niels H.

doi:10.1038/npjpcrm.2015.46

Cited by 58 publications

(56 citation statements)

References 60 publications

(71 reference statements)

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“…The asthma population varies in regard to asthma severity, health literacy, ability for self-management, and preference for mobile management [44], which makes generalizing findings from single studies and even reviews difficult. The exclusion of individuals with comorbidities also needs addressing as these are frequent in older individuals [1], and this may be contributing to the exclusion of older individuals within MTI research.…”

Section: Discussionmentioning

confidence: 99%

Mobile Technology Interventions for Asthma Self-Management: Systematic Review and Meta-Analysis

Miller

Schüz

Walters

et al. 2017

JMIR Mhealth Uhealth

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BackgroundMobile technology interventions (MTI) are becoming increasingly popular in the management of chronic health behaviors. Most MTI allow individuals to monitor medication use, record symptoms, or store and activate disease-management action plans. Therefore, MTI may have the potential to improve low adherence to medication and action plans for individuals with asthma, which is associated with poor clinical outcomes.ObjectiveA systematic review and meta-analysis were conducted to evaluate the efficacy of MTI on clinical outcomes as well as adherence in individuals with asthma. As the use of evidence-based behavior change techniques (BCT) has been shown to improve intervention effects, we also conducted exploratory analyses to determine the role of BCT and engagement with MTI as moderators of MTI efficacy.MethodsWe searched electronic databases for randomized controlled trials up until June 2016. Random effect models were used to assess the effect of MTI on clinical outcomes as well as adherence to preventer medication or symptom monitoring. Mixed effects models assessed whether the features of the MTI (ie, use of BCT) and how often a person engaged with MTI moderated the effects of MTI.ResultsThe literature search located 11 studies meeting the inclusion criteria, with 9 providing satisfactory data for meta-analysis. Compared with standard treatment, MTI had moderate to large effect sizes (Hedges g) on medication adherence and clinical outcomes. MTI had no additional effects on adherence or clinical outcomes when compared with paper-based monitoring. No moderator effects were found, and the number of studies was small. A narrative review of the two studies, which are not included in the meta-analysis, found similar results.ConclusionsThis review indicated the efficacy of MTI for self-management in individuals with asthma and also indicated that MTI appears to be as efficacious as paper-based monitoring. This review also suggested a need for robust studies to examine the effects of BCT use and engagement on MTI efficacy to inform the evidence base for MTI in individuals with asthma.

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Section: Discussionmentioning

confidence: 99%

Mobile Technology Interventions for Asthma Self-Management: Systematic Review and Meta-Analysis

Miller

Schüz

Walters

et al. 2017

JMIR Mhealth Uhealth

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“…Such system, if fact similar to SMS service, could also improve primary adherence in pair with e-prescription system (36). Other approaches described in the literature include mobile apps that stress the signi cance of proper clinical allergy diagnosis and further encourage patients' adherence (37)(38)(39).…”

Section: Discussionmentioning

confidence: 99%

Primary non-adherence to inhaled medications measured with e-prescription data from Poland

Kardas

Panek

Kuna

et al. 2020

Preprint

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Abstract Background: Treatment adherence greatly influences the clinical outcomes in various fields of medicine, including management of asthma and COPD. With the recent implementation of a nationwide e-Health solutions in Poland, new and unique opportunities for studying primary non-adherence in asthma and COPD emerged. The aim was to study primary non-adherence to inhaled medications available in Poland indicated in asthma and/or COPD and analyse the impact of patients’ demographics and inhalers’ characteristics (dry powder inhalers (DPIs) vs metered dose inhalers (MDIs) and presence of a dosage counter) on primary non-adherence. Methods: A retrospective analysis of all e-prescriptions issued in Poland in 2018 (n=119,880) from the national e-prescription pilot framework.Results: Primary non-adherence for inhalable medications reached 15.3%. It significantly differed among age groups – the lowest (10.8%) was in 75+ years-old patients, highest (18%) in 65-74 years-old patients. No gender differences in primary non-adherence were found. The highest non-adherence was observed for ICS + LABA combinations (18.86%). A significant difference was found MDI and DPI inhalers and between inhalers with/without a dosage counter.Conclusions: Out of e-prescriptions for inhaled medications issued in 2018 in Poland, 15.3% were not redeemed. The degree of primary non-adherence was influenced by age, but not gender. Significant differences between MDIs and DPIs and between inhalers with/without a dosage counter were observed.

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“…All three types of non-adherence benefit from individualized interventions by pharmacists (van Boven, 2015). Not every type of non-adherence can be addressed by simply retraining a patient to use an inhaler correctly.…”

Section: Discussionmentioning

confidence: 99%

“…The World Health Organization recommends that healthcare providers have a good understanding of the complexity of patient adherence in the management of asthma (World Health Organization, 2003). Three types of non-adherence have been defined by WHO: erratic non-adherence, intelligent non-adherence, and unwitting nonadherence (World Health Organization, 2003;van Boven, 2015). Erratic non-adherence is the most common form of non-adherence and is often referred to as forgetfulness.…”

Section: Discussionmentioning

confidence: 99%

Examining Pharmacists’ Knowledge, Skills and Self-efficacy when Counseling the Patient with Respiratory Disease

Buxton

Bruskiewitz²,

Kopacek³

2016

JCEPD

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Objectives. Inadequate counseling may lead to poor adherence in patients with respiratory disease. This study was designed to examine the impact of a professional development program on pharmacist's knowledge, skills and self-efficacy to provide inhaler counseling. Methods.Pharmacists participated in a live day long professional development activity consisting of morning lectures and an afternoon hands-on training session. Primary outcome measures included pre-and post-video critiques assessing the participant's knowledge, skills and self-efficacy with aspects of providing counseling to patients with respiratory conditions. Results. Pharmacist knowledge, self-efficacy and perceived ability to counsel patients in the proper techniques for inhaler use significantly improved after the activity, suggesting value in using a combination of teaching strategies.Conclusions. This program improved pharmacists' knowledge, skills and self-efficacy to counsel patients on inhaler use, with pharmacists indicating their commitment to make changes to their methods of counseling.Practice Implications. A combination of teaching strategies for continuing professional development can lead to improved pharmacist knowledge, skills and self-efficacy, with pharmacists committed to improving their patient counseling techniques. Improvements in patient counseling will result in better adherence rates in their patients, thus leading to improved health care outcomes.

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Towards tailored and targeted adherence assessment to optimise asthma management

Cited by 58 publications

References 60 publications

Mobile Technology Interventions for Asthma Self-Management: Systematic Review and Meta-Analysis

Mobile Technology Interventions for Asthma Self-Management: Systematic Review and Meta-Analysis

Primary non-adherence to inhaled medications measured with e-prescription data from Poland

Examining Pharmacists’ Knowledge, Skills and Self-efficacy when Counseling the Patient with Respiratory Disease

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