Asthma adherence: how can we help our patients do it better?

Shams, Marissa; Fineman, Stanley

doi:10.1016/j.anai.2013.10.013

Cited by 15 publications

(16 citation statements)

References 19 publications

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“…Therefore, clinicians should be encouraged to participate in collaborative, shared decision making with patients on omalizumab therapy about how to improve and maintain adherence to dosing schedules. 21,22 Although these strategies are important in all prescribed therapies, the cost of omalizumab therapy makes this prospective approach essential. Based on the present findings from the EXCELS data, one can project that a younger nonwhite patient with asthma and better lung function is likely to have more problems with consistent adherence than older white patients with worse lung function.…”

Section: Discussionmentioning

confidence: 99%

Omalizumab adherence in an observational study of patients with moderate to severe allergic asthma

Janson

Solari²,

Trzaskoma³

et al. 2015

Annals of Allergy, Asthma & Immunology

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Section: Discussionmentioning

confidence: 99%

Omalizumab adherence in an observational study of patients with moderate to severe allergic asthma

Janson

Solari²,

Trzaskoma³

et al. 2015

Annals of Allergy, Asthma & Immunology

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“…A recent review of asthma education determined that if asthma education is to result in long-term health outcomes, an approach to asthma education which is delivered routinely and keeps the shared patient and health care professional goals in mind, is required [66]. This is supported by research identifying the importance of communication in enhancing asthma patient's experiences, fostering engagement, and encouraging the patient to follow through their treatment plans [40,60,67,68]. Further to that, a literacy-sensitive, culturally and linguistically appropriate approach should also be incorporated [69][70][71][72][73].…”

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confidence: 92%

Identifying Critical Errors: Addressing Inhaler Technique in the Context of Asthma Management

et al. 2018

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Medication use has always played a highly significant role in the overall management of asthma, with appropriate use being linked to good asthma control. However, while patients with asthma enjoy the 'luxury' of having medications delivered directly to the lungs via inhaler devices, with that comes the additional challenge of ensuring that inhaler devices are used correctly. Research and practice provides evidence to the challenges associated with inhaler use and the particular steps that patients perform incorrectly. While this problem is well documented, acknowledged and reported, little has changed in 40 years, and the proportion of patients using inhaler devices remains unacceptably high. This review focuses on aspects specific to the errors that patient's make, the significance of these errors, and the important considerations for health care practitioners in supporting patients in correctly using their inhalers. This review highlights the complexities associated with patient's making inhaler technique errors and highlights the opportunities that lie in future technological developments of inhaler devices. Now more than ever, in the era of precision medicine, it is important that we address inhaler technique use once and for all.Keywords: Asthma control; Critical errors; Health behavior; Health care practitioners; Inhaler devices; Maintenance; Mastery; Skills THE IMPORTANCE OF MEDICATION USE IN OUR UNDERSTANDING OF RESPIRATORY DISEASEAfter decades of research, practice, and perceived knowledge, we find ourselves at crossroads in our understanding and management of airway diseases, such as asthma [1]. While asthma is an obstructive airways disease, which Pulm Ther (2018) 4:1-12 https://doi.org/10.1007/s41030-018-0051-0 to our current knowledge can neither be prevented nor cured, it is a disease that fluctuates in severity and 'control', is exacerbated by varying triggers, and its course over an individual's lifetime is essentially unpredictable [1]. While the conversation about asthma and airways disease more broadly is not the focus of this review, it becomes particularly relevant in our consideration of the use of medications. It is critical, now more than ever, that we understand the role of medication use, as it can provide us with further understanding about respiratory disease more broadly [2]. Given that asthma management is reliant on the use of medications [3], ensuring that patients use their medications correctly has become more than just a practical matter; it is a complex and critical issue. Correct medication use has become a fundamental step in our exploration and understanding of disease traits [1,2]: with careful and more precise evaluation of patient's response to treatment becoming integral to our understanding of disease endotypes and our evolution towards precision medicine [1,2]. For this reason, if for no other, it is now more important than ever that we address inhaler use, especially our knowledge of critical errors, which can 'cloud' our understanding of treatment success. T...

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“…Current data report poor adherence remaining as high as 50-90% and incorrect inhaler technique at 70-80% [9,10,12,20]. There is an abundance of literature providing insights into why patients use their medications inappropriately [21,22]; however, the solutions are complex, require significant and often additional resources, and need to be implemented continually Copyright ©ERS 2016 over time [22][23][24]. Is it therefore reasonable that one primary healthcare provider should take on the burden of addressing all of these issues, alone?…”

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confidence: 99%

Asthma management in primary care: caring, sharing and working together

Bosnic‐Anticevich

2016

Eur Respir J

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@ERSpublicationsWhy aren't primary care physicians and pharmacists collaborating more to manage and monitor asthma medication issues? http://ow.ly/YB2p6While historically chronic illnesses have been "stewarded" by different practitioners in different countries [1] with the increasing number of people with chronic illnesses and the ever rising costs of healthcare, the primary care setting is viewed as the long-term custodian of chronic illness management [2][3][4]. For people with asthma, quality management in primary care is a real, viable and accessible solution to asthma care. This is reflected in guidelines [2,5, 6], in research trends (as we see pragmatic research sourcing participants in primary care) [7,8] and it is evidenced in a multitude of primary healthcare initiatives established to support primary care physicians to optimally manage asthma in the community.Optimal asthma management: are we achieving it? Or is it an enigma? These are questions that primary care researchers and healthcare practitioners have been burdened with for a long time. Why? Because evidence, from large-scale and population-based studies confirms that, despite our ever-increasing knowledge and the abundance of research in the practice/clinical field, asthma remains a major health and economic burden. It is estimated that ∼300 million people live with asthma world-wide [2] and a high proportion of people living with asthma are classified as having poorly controlled disease [4,[9][10][11][12][13]. Asthma has significant economic impact both on individuals and on the healthcare system. A recent report determined that the net annual value of the burden of disease of asthma in Australia (based on disability-adjusted life years) was AUD 24.7 billion, with projected government costs for 2016-2019 being AUD 4.0 billion [14].For primary care practitioners, the current status of asthma in the community is at the very least disappointing, if not frightening; especially given the efforts put into improving asthma care at all levels (health system, research, global reports, practice initiatives, patient support and public awareness). The reality is that the multifaceted initiatives are falling short of addressing the multifactorial issues associated with sub-optimal management in real life [2,10,11,[15][16][17][18]: issues spanning across patient, healthcare practitioners and healthcare-system domains [12,19].One of the major issues in practice is asthma medication use. Medication management is a well-recognised, documented and investigated aspect of asthma management. Consistently research and practice indicate that many of the issues associated with sub-optimal management of asthma are related to the way in which people use their medicines, i.e. a high proportion of patients are nonadherent and a majority do not master or maintain correct inhaler technique [9,10]. Effective solutions to inappropriate and incorrect asthma medication use have been identified through high quality research; however, if these strategies are being implemented in...

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Asthma adherence: how can we help our patients do it better?

Cited by 15 publications

References 19 publications

Omalizumab adherence in an observational study of patients with moderate to severe allergic asthma

Omalizumab adherence in an observational study of patients with moderate to severe allergic asthma

Identifying Critical Errors: Addressing Inhaler Technique in the Context of Asthma Management

Asthma management in primary care: caring, sharing and working together

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