Measuring compliance with inhaled medication in asthma.

Coutts, J. R. T.; Gibson, Neil; Paton, James Y.

doi:10.1136/adc.67.3.332

Cited by 245 publications

(129 citation statements)

References 4 publications

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“…Overuse of the inhaler was estimated indirectly in this way by counting the remaining doses and found to be 7% in the present study, but other studies have shown similar estimates of overuse of medication in trials [5]. The possibility that the actual number of remaining doses overestimates drug adherence ("clicking" the inhaler without inhaling) cannot be ruled out.…”

Section: Discussionsupporting

confidence: 50%

“…The possibility that the actual number of remaining doses overestimates drug adherence ("clicking" the inhaler without inhaling) cannot be ruled out. This kind of overuse or "test firing" has been shown by others with the use of an electronic medication monitor in the inhaler [5,8]. This electronic instrument cannot confirm that the medication was inhaled or used correctly, but only when and how often the inhaler was actuated.…”

Section: Discussionmentioning

confidence: 98%

See 1 more Smart Citation

Patient compliance in a clinical trial with inhaled budesonide in children with mild asthma

Jonasson

Carlsen²,

Sodal³

et al. 1999

Eur Respir J

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Children's use of inhalation devices can give valuable information about their adherence to asthma therapy. The aim of this study was to examine treatment adherence of low dose inhaled budesonide or placebo administered via Turbuhaler1 twice daily in children with mild asthma participating in an asthma trial, by comparing diary registration with the number of doses remaining in the inhaler.A total of 163 children (age 7±16 yrs, 56 females, 107 males) with mild asthma (mean baseline forced expiratory volume in one second (FEV1) was 103% of predicted), were included into a double blind, randomized study. After a two-week run-in period, the children received inhaled budesonide, either 100 mg or 200 mg daily, and/or placebo for 12 weeks. All patients used daily diary cards throughout the study.Results from 161 patients were analysed. Mean compliance according to the diary was 93%, whereas estimated mean compliance when counting remaining doses in the Turbuhaler was 77%. Overuse of medication was found in 7% of the children. There was no significant difference in compliance between sex in the study group, whereas children aged #9 yrs had significantly better drug adherence than older children. No significant relationship was found between symptom score and compliance.In conclusion, even with optimal patient follow-up in a clinical trial, adherence to prophylactic asthma treatment is considerably lower than the patients own reports from the use of daily diary cards. Eur Respir J 1999; 14: 150±154.

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Section: Discussionsupporting

confidence: 50%

Section: Discussionmentioning

confidence: 98%

Patient compliance in a clinical trial with inhaled budesonide in children with mild asthma

Jonasson

Carlsen²,

Sodal³

et al. 1999

Eur Respir J

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“…From previous research, we know that parents and children with asthma are nonadherent, at least some of the time. 21,23 Characteristics of the disease, such as its episodic nature, make nonadherence with chronic medications more likely. Thus, the more interesting and important questions are how do families approach their management of the child's asthma and how do they think about adherence.…”

Section: Discussionmentioning

confidence: 99%

Self-reported Adherence, Management Behavior, and Barriers to Care After an Emergency Department Visit by Inner City Children With Asthma

et al. 1998

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ABSTRACT. Objective. The inability to adhere to a prescribed therapeutic program for the treatment of a chronic disease may be responsible in part for continued disease activity. This problem may be more of an issue in the treatment of asthma, a common, potentially lethal chronic condition in which the lack of symptoms may be interpreted as remission. Adherence was one of the key areas of interest for the National Cooperative Inner-City Asthma Study. The focus of this study was to identify those issues reported by families that could adversely affect their adherence to an asthma care program. The identification of barriers to adherence could then form the basis of a successful intervention program. This study describes barriers to adherence, asthma management behavior, and self-reported adherence.Methods. Patients presenting during an acute attack of asthma at an emergency department (ED) were recruited for this study. The medical record of the ED encounter was abstracted and compared with information that was obtained during a baseline interview 3 to 5 weeks later. During the baseline interview, parents were asked about health care behaviors related to adherence.Results. There were 344 children 4 to 9 years of age living in inner city census tracts in the study. Four areas of adherence (medicine use, appointment-keeping, emergency actions, and asthma attack prevention) were investigated. The parental report of medications prescribed at the ED and the information on the abstracted ED report agreed 94.9% of the time for the ␤-agonists, 86.8% for steroids, and 69.4% for cromolyn. Among respondents, 85.4% of parents reported that they are able to follow the ED recommendations almost all of the time; side effects of medicines were a concern for 81.1% of caretakers who were adherent and for 89.5% of caretakers who were nonadherent. Doubts regarding the usefulness of medications occurred in 34.4% of those considered adherent and 54.2% who admitted nonadherence. Medications were forgotten some of the time by 45.2% of the children, and 52.8% tried to get out of taking medicine. Appointments for follow-up care were kept by 69% of those given an appointment in the ED, by an estimated 60.0% of those who were told specifically to call for an appointment, and by an estimated 25.2% of those who were neither given an appointment nor told specifically to make one. Only one third of parents report that they were able to keep the child away from known asthma triggers nearly all of the time. Approximately half avoided allergens; however, only 37.5% reported avoidance of cigarette smoke. The use of preventive medicines occurred in 23.5%. Using a medicine and taking the child to a physician were reported as the first or second action during an acute attack of asthma by 72.1% of respondents.Conclusions. Adherence to an asthma-management program involves a number of areas: medication, appointment-keeping, prevention, and applying an emergency plan of action. Barriers to adherence may exist in one or all four of these areas, leading to...

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“…Using self-report (including the use of questionnaires) is the most commonly used method to assess adherence in clinical practice [3][4][5]. However, this approach can be susceptible to misrepresentation and may overestimate a patient's adherence [4] due to social desirability bias, i.e., reporting to the researchers or clinicians "what they want to hear" [3,4,[6][7][8].…”

Section: Medication Adherence In Childrenmentioning

confidence: 99%

Medication Adherence in Children

Alsous¹

2017

J Healthc Commun

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Measuring compliance with inhaled medication in asthma.

Cited by 245 publications

References 4 publications

Patient compliance in a clinical trial with inhaled budesonide in children with mild asthma

Patient compliance in a clinical trial with inhaled budesonide in children with mild asthma

Self-reported Adherence, Management Behavior, and Barriers to Care After an Emergency Department Visit by Inner City Children With Asthma

Medication Adherence in Children

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