Patient compliance with inhaled medication: does combining beta-agonists with corticosteroids improve compliance?

Abstract

P Pa at ti ie en nt t c co om mp pl li ia an nc ce e w wi it th h i in nh ha al le ed d m me ed di ic ca at ti io on n: : D Do oe es s c co om mb bi in ni in ng g b be et ta a--a ag go on ni is st ts s w wi it th h c co or rt ti ic co os st te er ro oi id ds s i im mp pr ro ov ve e c co om mp pl li ia an nc ce e? ? In an open, multicentre, parallel group study 102 asthmatic patients were randomly divided into two groups, either receiving the two drugs in separate Turbuhalers or combined into one Turbuhaler. A twice daily regimen was prescribed and a preweighed metered-dose inhaler (MDI) of salbutamol was provided for rescue use. Compliance was measured using the Turbuhaler Inhalation Computer (TIC), which recorded the time and date of each inhalation over a 12 week period. Forced expiratory volume in one second (FEV 1 ) and forced vital capacity (FVC) measurements were carried out at week 0, 6 and 12.Results from 72 patients were analysed. The average compliance was 60-70%. Treatment was taken as prescribed on 30-40% of the study days, and over-usage occurred on less than 10% of days. Only 15% of patients took the drugs as prescribed for more than 80% of the days.Compliance was no greater in patients using the combined inhalers. Other ways of improving patient self-management need further investigation.

A Review of the Effects of Medication Delivery Systems on Treatment Adherence in Children with Asthma

“…Study results 16,30,[34][35][36][37][38][39] are shown in Table II. Some of these studies have been summarized previously.…”

“…Bosley et al 39 compared compliance with inhaled budesonide, terbutaline, and the 2 dry combinations in the Turbuhaler. In this open-label, multicenter study, 102 asthmatic patients were given the 2 drugs in separate Turbuhalers or combined in one.…”

Difficult/therapy-resistant asthma The need for an integrated approach to define clinical phenotypes, evaluate risk factors, understand pathophysiology and find novel therapies

“…Compliance to inhaled corticosteroid therapy in asthma has been reported to be 30±70% [25,26]. How much this contributes to poor asthma control is not known.…”

Optimal cut-off value and clinical usefulness of the Adherence Starts with Knowledge-12 in patients with asthma taking inhaled corticosteroids

“…Therefore, the Global Initiative for Asthma (GINA) stated that follow-up consultations including assessment of patients' medication adherence and evaluation of inhaler device technique should occur at regular intervals (7). Currently, a variety of methods exist to assess adherence including medication counting (8,9), diaries, electronic monitors (10,11), questionnaires (12)(13)(14), and analysis of pharmacy claims databases (15)(16)(17). Some simple selfreported adherence questionnaires have been previously studied (12,18,19).…”