Adherence and quality of life assessment in patients with asthma treatment with budesonide/formoterol via the Elpenhaler device: the COMPLETE study

Exarchos, Konstantinos P.; Ρovina, Νikoletta; Krommidas, George; Latsios, Dimitrios; Gogali, Athena; Κostikas, Κonstantinos

doi:10.1186/s12890-022-02049-0

Cited by 9 publications

(6 citation statements)

References 33 publications

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“…This association was particularly identified with the asthma-specific questionnaire PROMIS-PAIS, likely due to its focused content, which is potentially more responsive to asthma symptoms ( Wiebe et al, 2003 ). Although the specific association of adherence with HRQoL has been less frequently examined, our results are consistent with findings of a systematic review in adolescents ( Usmani et al, 2018 ) and a multicenter, observational, prospective study in Greek adults with variable asthma severity ( Exarchos et al, 2022 ). Additionally, a longitudinal study in Dutch adolescents ( Tiggelman et al, 2015 ) indicated that higher HRQoL at baseline predicted increased medication adherence at follow-up, although good medication adherence did not predict an increase in HRQoL over time.…”

Section: Discussionsupporting

confidence: 89%

Impact of treatment adherence and inhalation technique on asthma outcomes of pediatric patients: a longitudinal study

Lizano-Barrantes,

Garin,

Mayoral

et al. 2024

Front. Pharmacol.

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Introduction: We aimed to evaluate the longitudinal relationships, both at between- and within-person levels, that adherence to inhaled corticosteroid-based maintenance treatment and inhalation technique present with symptom control, exacerbations, and health-related quality of life (HRQoL) in children and adolescents with asthma.Methods: Participants (6–14 years old) from the ARCA (Asthma Research in Children and Adolescents) cohort—a prospective, multicenter, observational study (NCT04480242)—were followed for a period from 6 months to 5 years via computer-assisted telephone interviews and a smartphone application. The Medication Intake Survey–Asthma (MIS-A) was administered to assess the implementation stage of adherence, and the Inhalation Technique Questionnaire (InTeQ) was used to assess the five key steps when using an inhaler. Symptom control was measured with the Asthma Control Questionnaire (ACQ), and HRQL was measured with the EQ-5D and the Patient-Reported Outcomes Measurement Information System–Pediatric Asthma Impact Scale (PROMIS-PAIS). Multilevel longitudinal mixed models were constructed separately with symptom control, exacerbation occurrence, EQ-5D, and PROMIS-PAIS as the dependent variables.Results: Of the 360 participants enrolled, 303 (1,203 interviews) were included in the symptom control and exacerbation analyses, 265 (732) in the EQ-5D, and 215 (617) in the PROMIS-PAIS. Around 60% of participants were male subjects, and most of them underwent maintenance treatment with inhaled corticosteroids plus long-acting β-agonists in a fixed dose (73.3%). Within-person variability was 83.6% for asthma control, 98.6% for exacerbations, 36.4% for EQ-5D, and 49.1% for PROMIS-PAIS. At the within-person level, patients with higher adherence had better symptom control (p = 0.002) and HRQoL over time (p = 0.016). Patients with a better inhalation technique reported worse HRQoL simultaneously (p = 0.012), but they showed better HRQoL in future assessments (p = 0.012). The frequency of reliever use was associated with symptom control (p < 0.001), exacerbation occurrence (p < 0.001), and HRQoL (p = 0.042); and boys were more likely to present better symptom control and HRQoL than girls.Conclusion: Our results confirm longitudinal associations at the within-person level of the two indicators of quality use of inhalers: for adherence to maintenance treatment with symptom control and HRQoL, and for the inhalation technique with HRQoL. Although treatment adherence was shown to be excellent, a third of the participants reported a suboptimal inhalation technique, highlighting the need for actions for improving asthma management of the pediatric population.

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Section: Discussionsupporting

confidence: 89%

Impact of treatment adherence and inhalation technique on asthma outcomes of pediatric patients: a longitudinal study

Lizano-Barrantes,

Garin,

Mayoral

et al. 2024

Front. Pharmacol.

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show abstract

“…This association was particularly identified with the asthma-specific questionnaire PROMIS-PAIS, likely due to its focused content, potentially more responsive to asthma symptoms [78]. While the specific association of adherence with HRQoL has been less frequently examined, our results are consistent with findings of a systematic review in adolescents [20] and a multicenter, observational, prospective study in Greek adults with variable asthma severity [79]. Additionally, a longitudinal study in Dutch adolescents [30] indicated that higher HRQoL at baseline predicted increased medication adherence at follow-up, although good medication adherence did not predict an increase in HRQoL over time.…”

Section: Adherence To Ics-based Maintenance Treatmentsupporting

confidence: 87%

Impact of Treatment Adherence and Inhalation Technique on asthma outcomes of Pediatric Patients: A Longitudinal Study

Lizano-Barrantes,

Garin,

Mayoral

et al. 2023

Preprint

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IntroductionWe aimed to evaluate the longitudinal relationships, both at between- and within-person levels, that adherence to inhaled corticosteroids-based maintenance treatment and inhalation technique present with symptom control, exacerbations, and health-related quality of life (HRQoL) in children and adolescents with asthma.MethodsParticipants (6-14 years old) from the ARCA (Asthma Research in Children and Adolescents) cohort - a prospective, multicenter, observational study (NCT04480242) - were followed for a period from 6 months to 5 years, via computer-assisted telephone interviews and a smartphone application. The Medication Intake Survey–Asthma (MIS-A) was administered to assess the implementation stage of adherence; and the Inhalation Technique Questionnaire (InTeQ) to assess the five key steps when using an inhaler. Symptoms control was measured with the Asthma Control Questionnaire (ACQ), and HRQL with the EQ-5D and the PROMIS-Pediatric Asthma Impact Scale (PROMIS-PAIS). Multilevel longitudinal mixed models were constructed separately with symptom control, exacerbation occurrence, EQ-5D, and PROMIS-PAIS as dependent variables.ResultsOf 360 participants enrolled, 303 (1203 interviews) were included in the symptom control and exacerbation analyses, 265 (732) in the EQ-5D, and 215 (619) in the PROMIS-PAIS. Around 60% of participants were male and most underwent maintenance treatment with inhaled corticosteroids plus long-acting β-agonists in a fixed dose (68–74%). Within-person variability was 83.6% for asthma control, 98.6% for exacerbations, 36.4% for EQ-5D and 49.1% for PROMIS-PAIS. At within-person level, patients with higher adherence had better symptom control (p=0.002) and HRQoL over time (p=0.016). Patients with better inhalation technique reported worse HRQoL simultaneously (p=0.012), but better HRQoL in future assessments (p=0.012). Frequency of reliever use was associated with symptom control (p<0.001), exacerbation occurrence (p<0.001), and HRQoL (p=0.042); and boys were more likely to present better symptom control and HRQoL than girls.ConclusionOur results confirm longitudinal associations at within-person level of the two indicators of quality use of inhalers: for adherence to maintenance treatment with symptom control and HRQoL, and for inhalation technique with HRQoL. Although treatment adherence showed to be excellent, a third part of participants reported a suboptimal inhalation technique, highlighting the need of actions for improving asthma management of pediatric population.

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“…Conversations between physicians and patients addressed ICS overuse and lack of knowledge and beliefs about ICS. Exarchos et al [54] examined the adherence levels of 716 adult patients diagnosed with asthma receiving budesonide/formoterol fixed-dose combination (FDC) via the Elpenhaler device. The study showed that about 80% of patients presented a moderate to high level of adherence during the study.…”

Section: Medication Adherence In Asthmamentioning

confidence: 99%

Adherence to treatment recommendations of patients with chronic non-communicable respiratory diseases – a narrative review

Henryka¹

2023

J Educ Health Sport

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Despite modern therapeutic solutions, patients with chronic obstructive pulmonary disease (COPD) and asthma do not achieve therapeutic benefits due to emerging obstacles to compliance. This review aimed to present and analyze the results of available studies evaluating the influence of sociodemographic, clinical, and psychosocial factors on the level of adherence of patients with COPD and asthma. This narrative review was based on papers indexed in the following databases: PubMed, MEDLINE, CINAHL, Web of Science, and Scopus. The analyzed studies showed that the adherence level of patients with COPD and asthma is unsatisfactory, ranging from 23.6 to 80%. The main factors increasing the level of adherence of COPD patients mentioned in the analyzed studies were: unemployment, taking LAMA, not smoking cigarettes, belief that medication is necessary, higher education, use of multi-dose DPI and MDI inhalers, a greater sense of self-efficacy, and longer duration of disease. Independent determinants of good adherence of patients with asthma were better quality of life, high level of disease control, treatment with ICS + LABA or FF/UMEC/VI, good knowledge about asthma, and positive attitude towards the disease. According to available studies, determinants lowering adherence among patients with COPD were overweight or obesity, depression, poor quality of life, belief that treatment is harmful, frequent hospitalizations, lack of knowledge about the disease and treatment, sleep disorders, and use of ICS, LABA/ICS. Patients with asthma who received infrequent functional support consumed alcohol and were convinced of the harm and lack of need for treatment were non-adherent. In addition, an association was shown between high levels of adherence and a reduction in ED visits and hospitalizations in asthma and COPD patients.

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Adherence and quality of life assessment in patients with asthma treatment with budesonide/formoterol via the Elpenhaler device: the COMPLETE study

Cited by 9 publications

References 33 publications

Impact of treatment adherence and inhalation technique on asthma outcomes of pediatric patients: a longitudinal study

Impact of treatment adherence and inhalation technique on asthma outcomes of pediatric patients: a longitudinal study

Impact of Treatment Adherence and Inhalation Technique on asthma outcomes of Pediatric Patients: A Longitudinal Study

Adherence to treatment recommendations of patients with chronic non-communicable respiratory diseases – a narrative review

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