The Value of Participating in an Asthma Trial

Reiser, J.; Warner, Jill A.

doi:10.1016/s0140-6736(85)92037-9

Cited by 40 publications

(25 citation statements)

References 5 publications

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“…Simply monitoring adherence, even if feedback is not given, has been shown to increase the use of medication (24). It has also been observed that participating in a research study may result in improved clinical outcomes, even in control subjects (25). There may also be a ceiling effect, in which subjects with reasonable yet imperfect adherence have derived maximal benefit from their treatment (26).…”

Section: Discussionmentioning

confidence: 99%

Providing Feedback on Adherence Increases Use of Preventive Medication by Asthmatic Children

2010

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This study investigates the impact of measuring adherence and providing feedback on medication usage by children with unstable asthma. Adherence was measured using an electronic monitoring device. Subjects were randomized to either being told of their adherence during review consultations or for their adherence to remain undisclosed to their parents and treating physician. Subjects were reviewed monthly for 4 months. Twenty-six children aged between 6 and 14 years were recruited. Adherence was significantly higher in the intervention group (79% versus 58%, p <.01). There were significant improvements in clinical measures of disease control compared with baseline in both groups. The change in forced expiratory volume in 1 s (FEV(1)) (% predicted) was greater in those subjects receiving feedback (13.8% versus 9.8%). However, lung function values were lower in the intervention group at baseline and the relative improvement failed to reach statistical significance. Measuring adherence and providing feedback increases the use of preventive medication. A larger study is required to explore implications for disease control.

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Section: Discussionmentioning

confidence: 99%

Providing Feedback on Adherence Increases Use of Preventive Medication by Asthmatic Children

2010

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“…This is also true of the majority of placebo arms in placebo-controlled trials. This suggests that children with difficult asthma benefit from the high level of input that is typically provided in clinical trials, with or without additional medication (113). Such intensive management of patients, with the emphasis on establishing the diagnosis, improving adherence, and identifying provoking factors, is the key to optimizing asthma control for these children.…”

Section: Discussionmentioning

confidence: 99%

Children with Difficult Asthma: A Practical Approach

Payne¹,

Balfour‐Lynn²

2001

Journal of Asthma

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Many open studies investigating the effects of innovative treatments for steroid-dependent asthma demonstrate some benefit. This is also true of the majority of placebo arms in placebo-controlled trials. This suggests that children with difficult asthma benefit from the high level of input that is typically provided in clinical trials, with or without additional medication. Such intensive management of patients, with the emphasis on establishing the diagnosis, improving adherence, and identifying provoking factors, is the key to optimizing asthma control for these children. For patients with genuinely severe asthma, despite high doses of conventional treatment, a greater understanding of the pathological basis of persistent symptoms is needed. Identification of different pathological subtypes of severe asthma should allow for more rational prescribing of asthma therapy, as well as the design of further trials of potential steroid-sparing treatments.

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“…It has been shown that participating in a clinical trial can increase the patients motivation and compliance [11]. Only patients deemed to be compliant were selected for this trial.…”

Section: Discussionmentioning

confidence: 99%

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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The Value of Participating in an Asthma Trial

Cited by 40 publications

References 5 publications

Providing Feedback on Adherence Increases Use of Preventive Medication by Asthmatic Children

Providing Feedback on Adherence Increases Use of Preventive Medication by Asthmatic Children

Children with Difficult Asthma: A Practical Approach

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

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