Do you know when the inhaler is empty?

Fullwood, Isobel; Evans, T; Davies, Benjamin; Ninan, T; Onyon, Clare; Clarke, J; Srikanthiah, Rajesh; Frost, Susan; Iqbal, N; Atkinson, Maria; Rao, Satish; Nagakumar, Prasad

doi:10.1136/archdischild-2022-324027

Cited by 9 publications

(7 citation statements)

References 8 publications

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“…Interestingly, participants also indicated that they missed puffs because of inhalers being empty. Recent literature suggests that patients may not even know when their inhalers are empty, 24 leading to additional challenges. Effective adherence interventions may require individualized tailoring to medication belief patterns.…”

Section: Discussionmentioning

confidence: 99%

Encouraging adherence in adolescents with asthma using financial incentives: An RCT

Keyser

Brinton

Bothwell

et al. 2023

Pediatric Pulmonology

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BackgroundMedication adherence in adolescents remains a significant management challenge and innovative strategies are needed to improve medication adherence. Financial incentives have been used to improve outcomes for health behaviors among adults, but have not been well‐studied among adolescents. The objective of this study was to test if a modest financial incentive improved medication adherence in adolescents with asthma compared with a control group.MethodsParticipants were randomized to either control (electronic medication monitoring [EMM] with App reminders/feedback for 4 months) or intervention (EMM + $1 per day for perfect medication adherence for 3 months [maximum $84] followed by 1 month of EMM only). A repeated measures mixed model, with a first order autoregressive correlation structure between errors, was used to test the null hypothesis for an interaction of treatment group and week.ResultsFifty‐two participants were enrolled, and 48 completed primary analysis. Mean adherence rates declined in both groups over time, and there was no significant difference in the change in adherence rates between the groups (F‐statistic = 0.72, ndf = 15, ddf = 625, p = 0.76). Adherence rates (during the 12 weeks when incentives were given) declined from 80% to 64% in the control group, and from 90% to 58% in the incentive group. There was no significant change in the slope of decline in the incentives group in the month following payment discontinuation.ConclusionA modest financial incentive did not lead to significantly different medication adherence rates in adolescents with asthma who were receiving a monitoring and reminder intervention. Further study is needed to determine viable interventions to optimize medication use in this group.

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Section: Discussionmentioning

confidence: 99%

Encouraging adherence in adolescents with asthma using financial incentives: An RCT

Keyser

Brinton

Bothwell

et al. 2023

Pediatric Pulmonology

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“…Future studies should explore the impact of changes in healthcare delivery during and after the COVID-19 pandemic on asthma reviews after an asthma-related admission to hospital. The impact of telephone-based asthma reviews in particular needs to be evaluated as essential asthma care assessment, including checking inhaler technique and whether inhalers are empty, 20 cannot be adequately performed via a telephone review.…”

Section: Discussionmentioning

confidence: 99%

Post-hospitalisation asthma management in primary care: a retrospective cohort study

Punyadasa,

Simms-Williams,

Adderley

et al. 2023

Br J Gen Pract

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Background: Clinical guidelines recommend that patients admitted to hospital for asthma attacks are reviewed in primary care following hospital discharge. Aim: We evaluated post-hospitalisation asthma management in primary care and its associations with patient characteristics. Design and setting: A retrospective cohort study was performed using English primary care data from the Clinical Practice Research Datalink Aurum database and linked Hospital Episode Statistics Admitted Patient Care data. Method: Patients with asthma aged ≥5 years who had at least one asthma-related hospitalisation from 1st January 2017 to 31st December 2019 were included. The primary outcome was a composite of any of the following delivered in primary care within 28 days from hospital discharge: asthma review, asthma management plan, asthma medication prescriptions, demonstration of inhaler technique, or smoking cessation counselling. The association between patient characteristics and delivery of clinical care was assessed using logistic regression. Results: The study included 17,457 patients. 10,515 (60.2%) patients received the primary outcome within 28 days of hospital discharge. 2311 (13.2%) received an asthma review, 1459 (8%) an asthma management plan, 9996 (57.3%) an asthma medication, 1500 (8.6%) a demonstration of inhaler technique, and 52 (1.2% of smokers) had smoking cessation counselling. Patients from black ethnic minorities received less of this care (27-54% lower odds, depending on age). However, short-acting bronchodilator prescriptions in the previous year were associated with an increased likelihood of the primary outcome. Conclusion: A significant proportion of patients do not receive timely follow-up in primary care following asthma-related hospitalisations, particularly among black ethnic groups.

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“…Many inhalers do not have dose counters, which means there is a risk of patients throwing away partly used inhalers prematurely 17. Most inhalers are disposed of in domestic waste and, because of the lack of large scale recycling schemes globally, end up in landfill where their HFCs are leaked into the atmosphere.…”

Section: What Is the Problem?mentioning

confidence: 99%

Towards net zero: asthma care

Smith,

Bhugra,

Kelani

et al. 2023

BMJ

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Do you know when the inhaler is empty?

Cited by 9 publications

References 8 publications

Encouraging adherence in adolescents with asthma using financial incentives: An RCT

Encouraging adherence in adolescents with asthma using financial incentives: An RCT

Post-hospitalisation asthma management in primary care: a retrospective cohort study

Towards net zero: asthma care

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