Caregiver and pediatric provider perspectives on symptom-based inhaled corticosteroid therapy in asthma

Dy, Tiffany Biason; Lewis, Ericka M.; Murugan, Vithya; Gehlert, Sarah; Taylor, Juanita; Garbutt, Jane; Bacharier, Leonard B.; Castro, Mario; Sumino, Kaharu

doi:10.1016/j.rmed.2018.03.001

Cited by 9 publications

(3 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This is similar to other studies 13,37 whereby parents tried various ways to improve children's asthma control, such as the use of CAM and the home nebuliser. Parents feared the use of preventer medication for asthma would cause side effects and dependency, a common concern in Asian and western countries [38][39][40] . However, the use of CAMs without proper monitoring and over-reliance on the use of nebuliser at home could potentially lead to delay in seeking treatment, causing morbidity and even mortality 41 .…”

Section: Discussionmentioning

confidence: 99%

Perceptions of childhood asthma and its control among Malays in Malaysia: a qualitative study

Sukri

Ramdzan

Liew

et al. 2020

npj Prim. Care Respir. Med.

View full text Add to dashboard Cite

Children with poor asthma control have poor health outcomes. In Malaysia, the Malays have the highest asthma prevalence and poorest control compared to other ethnicities. We aimed to explore Malay children with asthma and their parents' perceptions on asthma and its control. We conducted focus group discussions (FGD) using a semi-structured interview guide. Interviews were audio-recorded, transcribed verbatim and analysed thematically. Sixteen children and parents (N = 32) participated. The perception of asthma was based on personal experience, cultural and religious beliefs, and there was mismatch between children and parents. Parents perceived mild symptoms as normal, some had poor practices, raising safety concerns as children were dependent on them for self-management. Conflicting religious opinions on inhaler use during Ramadhan caused confusion in practice. Parents perceived a lack of system support towards asthma care and asthma affected quality of life. Urgent intervention is needed to address misconceptions to improve asthma care in children.

show abstract

Section: Discussionmentioning

confidence: 99%

Perceptions of childhood asthma and its control among Malays in Malaysia: a qualitative study

Sukri

Ramdzan

Liew

et al. 2020

npj Prim. Care Respir. Med.

View full text Add to dashboard Cite

show abstract

“…Evidence supporting this approach comes from recent clinical trials that demonstrated the clinical equipoise between a symptom-driven ICS/LABA treatment strategy and traditional therapy (30)(31)(32)(33). However, prior studies have opined that providers are unaware of or skeptical of these latest recommendations (34,35).…”

Section: Update In 2019 Asthma Recommendationsmentioning

confidence: 99%

Symptom-driven inhaled corticosteroid/long-acting beta-agonist therapy for adult patients with asthma who are non-adherent to daily maintenance inhalers: a study protocol for a pragmatic randomized-controlled trial

Krings

Wojcik

Chen

et al. 2022

Preprint

Self Cite

View full text Add to dashboard Cite

BACKGROUNDWhile inhaled corticosteroids (ICS) are considered the essential foundation of most asthma therapy, ICS inhaler nonadherence is a notoriously common problem and a significant cause of asthma-related morbidity. Partially acknowledging the problem of nonadherence, international organizations recently made paradigm-shifting recommendations that all patients with mild-to-moderate persistent asthma be considered for symptom-driven ICScontaining inhalers rather than relying on adherence to traditional maintenance ICS inhalers and symptom-driven short-acting beta-agonists (SABA). With this new approach, asthma patients are at least exposed to the important anti-inflammatory effects of ICS-containing inhalers when their symptom reliever inhaler is deployed due to acute symptoms. METHODSThis study will ( Part 1 ) complete a pragmatic randomized-controlled trial to evaluate if an inhaler strategy that utilizes symptom-driven ICS inhalers is particularly beneficial in maintenance ICS inhaler non-adherent asthma patients, and ( Part 2 ) use a dissemination and implementation (D&I) science conceptual framework to better understand patients’ and providers’ views of inhaler nonadherence. This study, which will have an option of taking place entirely remotely, will use a Food and Drug Administration (FDA)-approved electronic sensor (Hailie® sensor) to monitor inhaler adherence and includes semi-structured interviews guided by the Consolidated Framework for Implementation Research (CFIR). DISCUSSIONThis study is assessing the problem of nonadherence using a D&I implementation science research lens while testing a new inhaler approach to potentially ameliorate the detrimental consequences of maintenance inhaler nonadherence. We hypothesize that the use of a symptom-driven ICS/LABA management strategy, as compared to traditional maintenance ICS treatment and symptom-driven SABA, will lead to improved adherence to an asthma treatment strategy, decreased asthma-related morbidity, less cumulative ICS exposure, and greater patient satisfaction with an inhaler approach. TRIAL REGISTRATIONThe study was registered via ClinicalTrials.gov on November 8, 2021. The registration number is NCT05111262.

show abstract

“…Evidence supporting this approach comes from recent clinical trials that demonstrated the clinical equipoise between a symptom-driven ICS/LABA treatment strategy and traditional therapy [33][34][35][36]. However, prior studies have opined that providers are unaware of or skeptical of these latest recommendations [37,38].…”

Section: Rationale For This Study Update In 2019 Asthma Recommendationsmentioning

confidence: 99%

Symptom-driven inhaled corticosteroid/long-acting beta-agonist therapy for adult patients with asthma who are non-adherent to daily maintenance inhalers: a study protocol for a pragmatic randomized controlled trial

Krings

Wojcik

Chen

et al. 2022

Trials

Self Cite

View full text Add to dashboard Cite

Background While inhaled corticosteroids (ICS) are considered the essential foundation of most asthma therapy, ICS inhaler nonadherence is a notoriously common problem and a significant cause of asthma-related morbidity. Partially acknowledging the problem of nonadherence, international organizations recently made paradigm-shifting recommendations that all patients with mild-to-moderate persistent asthma be considered for symptom-driven ICS-containing inhalers rather than relying on adherence to traditional maintenance ICS inhalers and symptom-driven short-acting beta-agonists (SABA). With this new approach, asthma patients are at least exposed to the important anti-inflammatory effects of ICS-containing inhalers when their symptom reliever inhaler is deployed due to acute symptoms. Methods This study will (Part 1) complete a pragmatic randomized controlled trial to evaluate if an inhaler strategy that utilizes symptom-driven ICS inhalers is particularly beneficial in maintenance ICS inhaler non-adherent asthma patients, and (Part 2) use a dissemination and implementation (D&I) science conceptual framework to better understand patients’ and providers’ views of inhaler nonadherence. This study, which will have an option of taking place entirely remotely, will use a Food and Drug Administration (FDA)-approved electronic sensor (Hailie® sensor) to monitor inhaler adherence and includes semi-structured interviews guided by the Consolidated Framework for Implementation Research (CFIR). Discussion This study is assessing the problem of nonadherence using a D&I implementation science research lens while testing a new inhaler approach to potentially ameliorate the detrimental consequences of maintenance inhaler nonadherence. We hypothesize that the use of a symptom-driven ICS/LABA management strategy, as compared to traditional maintenance ICS treatment and symptom-driven SABA, will lead to improved adherence to an asthma treatment strategy, decreased asthma-related morbidity, less cumulative ICS exposure, and greater patient satisfaction with an inhaler approach. Trial registration ClinicalTrials.gov NCT05111262. Registered on November 8, 2021.

show abstract

Caregiver and pediatric provider perspectives on symptom-based inhaled corticosteroid therapy in asthma

Cited by 9 publications

References 11 publications

Perceptions of childhood asthma and its control among Malays in Malaysia: a qualitative study

Perceptions of childhood asthma and its control among Malays in Malaysia: a qualitative study

Symptom-driven inhaled corticosteroid/long-acting beta-agonist therapy for adult patients with asthma who are non-adherent to daily maintenance inhalers: a study protocol for a pragmatic randomized-controlled trial

Symptom-driven inhaled corticosteroid/long-acting beta-agonist therapy for adult patients with asthma who are non-adherent to daily maintenance inhalers: a study protocol for a pragmatic randomized controlled trial

Contact Info

Product

Resources

About