Factors Influencing Adherence to The Use of Inhalers for Control of Asthma in Adult Out-Patients in a Nigerian Teaching Hospital (original) (raw)
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Assessing the use of MDI among asthmatic patients in Saudi Arabia
Background: Asthma is an important public health problem worldwide on account of its prevalence. Education of asthmatic patients about appropriate using of MDIs would be more effective medications. Objectives: To assess the appropriateness of using MDIs among asthmatic patients and to determine the factors significantly associated with correct use of MDI. Method: A descriptive study was conducted on 399 asthmatic patients on internet on Google from 28th October to 28th November 2015. A questionnaire was filled out and SPSS version 21 was used for data analysis. Standard method was used to obtain descriptive statistic comprising means, percentage and standard deviations in order to describe demographic variables. Analysis of variance (ANOVA) test was used to compare means of contentious and categorical variables of demographic characteristics and medical background with using MDIs and find association between them. P-value of 0.05 and less were regarded as statistically significant. Results: In the studied sample, 87% were age less than 45 years, 74% of cases were females. About 92% of cases were higher and above level of education. More than half of subjects had asthma for more than five years. There were 36% of patients using MDI. Only a few patients (12%) had the correct all skills using MDIs. There were significant association between using MDIs with age and duration of asthma (p=<0.001). Conclusions: Despite the well-known fact that a good MDI technique is of greatest importance, Majority of asthmatic patients have poor skills of MDI appropriate use. Incorrect MDIs technique is common among asthma patients. Health care professional must be focused on training on use MDI among the younger and newly diagnosis asthmatic patients. This indicating the need for regular formal training programmes on inhaler techniques so as to decipher correct practices in inhalation therapy.
2013
Conclusion: Our findings indicate that, despite ongoing treatment, asthma control rate was 61.5% at visit 1 in adult outpatients with persistent asthma. However, by the final follow-up 6 months later, this had increased to 87.3%, independent of sociodemographic and clinical characteristics. Poor asthma control was associated with asthma-related comorbid diseases, while the efficacy of fixed dose combinations was evident in the achievement of asthma control. Sign up to receive Journal of Asthma and Allergy here: http://www.dovepress.com/factors-influencing-asthma-control-results-of-a-real-life-prospective--peer-reviewed-article-JAA
Canadian Respiratory Journal
Asthma is a heterogeneous disease which is characterized by chronic airway inflammation. It is a common chronic respiratory disease affecting 1–18% of population in different countries. It can be treated mainly with inhaled medications in several forms, including pressurized metered-dose inhaler (MDI). Patients encountered difficulty in using inhaler devices even after repeated demonstration and/re-evaluation. This could highly compromise patient treatment outcome/asthma control. To evaluate relationship between MDI use technique and asthma control among adult asthmatic patients who attend respiratory clinic in Jimma University Medical Center (JUMC), Southwest Ethiopia. A prospective observational study was conducted from March to August 22, 2018. All adult asthmatic patients who met the inclusion criteria were included in the study. Patient baseline assessment was conducted (patient demography, inhalation technique, adherence, and asthma control status). Inhalation technique was ob...
Primary Care Respiratory Journal, 2013
Background: In practice it is logical that inhalers are prescribed only after patients have received training and demonstrated their ability to use the device. However, many patients are unable to use their pressurised metered-dose inhaler devices (pMDIs) correctly. We assessed the relationship between asthma control and patients' ability to use their prescribed pMDIs. Methods: Evaluation of 3,981 (46% male) primary care asthma patient reviews, which included inhaler technique and asthma control, by specialist nurses in primary care in 2009. The paper focuses on people currently prescribed pMDI devices. Results: Accurate data on reliever and preventer inhaler prescriptions were available for 3,686 and 2,887 patients, respectively. In patients prescribed reliever inhalers, 2,375 (64%) and 525 (14%) were on pMDI alone or pMDI plus spacer, respectively. For those prescribed preventers, 1,976 (68%) and 171 (6%) were using a pMDI without and with a spacer, respectively. Asthma was controlled in 50% of patients reviewed. The majority of patients (60% of 3,686) were using reliever pMDIs, 13% with spacers. Incorrect pMDI use was associated with poor asthma control (p<0.0001) and more short burst systemic steroid prescriptions in the last year (p=0.038). Of patients using beclometasone (the most frequently prescribed preventer drug in our sample), significantly more of those using a breath-actuated pMDI device (p<0.0001) and a spacer (p<0.0001) were controlled compared with those on pMDIs alone. Conclusions: Patients who are able to use pMDIs correctly have better asthma control as defined by the GINA strategy document. Beclometasone via a spacer or breath-actuated device resulted in better asthma control than via a pMDI alone. Patients prescribed pMDIs should be carefully instructed in technique and have their ability to use these devices tested; those unable to use the device should be prescribed a spacer or an alternative device such as one that is breath-actuated.
International Journal of Tuberculosis and Lung Disease, 2016
To investigate associations between technique with pressurised metered-dose inhalers (pMDIs) and dry powder inhalers (DPIs) used as controller medication and asthma control variables measured using Asthma Control Test (ACT) scores. D E S I G N : In this cross-sectional study, the inhaler technique of asthma patients using pMDIs or DPIs (Turbuhaler w [TH] and Accuhaler Diskuse [ACC]) were assessed against published inhaler technique checklists. ACT scores (maximum 25, higher score corresponding to better asthma control) were assessed. R E S U LT S : Of the 130 subjects enrolled in the study (41 TH, 54 ACC and 35 pMDI), inhaler technique scores (out of nine for all devices) were low for TH (4.4 6 0.9) and ACC (5.4 6 1.0) compared with pMDI (8.1 6 0.9) (P , 0.001, one-way analysis of variance). Older age
Factors Contributing Towards Poor Asthma Control in Patients on Regular Medication
Journal of Clinical and Diagnostic Research, 2016
Introduction: In-spite of the availability of effective medications, it is observed that patients with bronchial asthma on treatment are poorly controlled. An objective evaluation of asthma control especially with respect to inflammation and the factors contributing towards poor control is crucial in obtaining relief of symptoms. Aim: 1) To measure the asthma control using modified Mini Asthma Quality Of Life Questionnaire (MAQOL) and sputum eosinophil count; 2) To identify the role of factors viz. age, duration of asthma, severity, compliance, technique of inhalation and knowledge of asthma action plan on asthma control. Materials and Methods: Total 50 asthmatic patients on regular medication were included in the study after obtaining written informed consent. The asthma-control was evaluated based on history, clinical symptoms, need for short-acting bronchodilators, FEVs1 and sputum eosinophil count with the help of modified MAQOL. A global score of <80% was considered as poor control. The proportion of patients under each factor, in poorly-controlled group (PC) was compared with the well-controlled group (WC). The results were analysed using descriptive statistics and unpaired student’s t-test. Results: Of the total, 33 (66%) patients were in PC category with a mean global asthma score of 58.46 ± 2.881 vs 85.2 ± 1.19 in the WC group (34%) (p<0.05). The mean age in PC was 41.41 ± 2.413 vs 29.00 ± 2.157(p<0.05) in the WC. The mean duration of asthma was 16.76 ± 2.761 in PC vs 7.882 ± 2.065 years in WC (p<0.05). The severity score was 7.265 ± 0.4434 in PC vs 6.706 ± 0.64 in WC. Eight patients in PC and six in WC were unaware of the treatment plan. One in PC group and three in WC were unaware of technique of inhalation. One in PC group and three in WC were non–compliant. Mean sputum eosinophil count was 7.441 ± 1.081 in PC vs 5.176 ± 1.201 in WC. Conclusion: MAQOL is useful in evaluating asthma-control. Sputum eosinophil count correlates with asthma-control. Duration of asthma, age and severity contributed significantly to the poor control of asthma. There is a need for an objective monitoring in asthma and the treatment strategies need to be modified accordingly.
Influence of patients' characteristics and disease management on asthma control
Journal of Allergy and Clinical Immunology, 2006
Background: Although asthma control is a major outcome in disease management, little is known about its determinants. Objectives: We sought to study the relationships between asthma control and patient characteristics or asthma management. Methods: Asthmatic patients (age 18-50 years) who were regular customers of pharmacies and had a prescription for an antiasthma medication were recruited consecutively. Patients completed a questionnaire, which was complemented by computerized pharmacy records of previously dispensed medications. Asthma control (adequate/inadequate) was assessed with the Asthma Control Test. Determinants of asthma control were identified by means of multivariate logistic regression analysis. Results: The mean age of the 1351 patients included was 36.8 years (SD, 9.8), and 55.8% were women. A minority of patients were considered to have had their symptoms adequately controlled. Smoking, female sex, and a body mass index of greater than 30 kg/m 2 were all independent determinants of inadequate control. Compared with patients receiving inhaled corticosteroid monotherapy, those who were dispensed fixed combinations of inhaled corticosteroids and long-acting bagonists presented with a significantly lower risk of inadequate asthma control (odds ratio, 0.58; 95% CI, 0.35-0.96). Conclusion: Asthma control varied according to both the patients' characteristics and therapy. Clinical implications: Our results strongly support the need to improve asthma control, especially in primary care and in women. A regular use of fixed controller combinations, helping patients to quit smoking, or addressing weight issues might contribute to improvement in asthma control. (J Allergy Clin
Value in Health, 2015
Objective: To identify the impact of delivery device of inhaled corticosteroids and long-acting β 2-agonist (ICS/LABA) on asthma medication compliance, and investigate other factors associated with compliance. Materials and methods: We conducted a retrospective and multicenter study based on a review of medical registries of asthmatic patients treated with ICS/LABA combinations (n=2,213) whose medical devices were either dry powder inhalers (DPIs, such as Accuhaler ® , Turbuhaler ® , and NEXThaler ®) or pressurized metered-dose inhalers (pMDI). Medication compliance included persistence outcomes through 18 months and medication possession ratios. Data on potential confounders of treatment compliance such as asthma exacerbations, comorbidities, demographic characteristics, and health care resource utilization were also explored. Results: The probability of asthma medication compliance in case of DPIs was lower compared to pMDIs, which suggests that inhaler devices influence inhalation therapies. There were additional confounding factors that were considered as explanatory variables of compliance. A worse measure of airflow obstruction (forced expiration volume in 1 second), comorbidities and general practitioner (GP) consultations more than once per month decreased the probability of compliance. Within comorbidities, alcoholism was positively associated with compliance. Patients of 29-39, 40-50, and 51-61 age groups or suffering from more than two exacerbations during the study period were more likely to comply with their medication regime. The effects of DPIs toward compliance varied with the different DPIs. For instance, Accuhaler ® had a greater negative effect on compliance compared to Turbuhaler ® and Nexthaler ® in cases of patients who suffered exacerbations. We found that GP consultations reduced the probability of medication compliance for patients treated with formoterol/budesonide combination. For retired patients, visiting the GP increased the probability of medication compliance. Conclusion: We concluded that inhaler devices influence patients' compliance for long-term asthma medication. The impact of Accuhaler ® , Turbuhaler ® , and NEXThaler ® on medication compliance was negative. We also identified some confounders of medication compliance such as patient's age, severity of asthma, comorbidities, and health care costs.
Factors Associated with the Appropriate Use of Asthma Drugs
Canadian Respiratory Journal, 2011
BACKGROUND: When used properly, asthma drugs can reduce asthma-related morbidity and mortality.OBJECTIVE: To assess the use of asthma drugs, and to identify factors associated with appropriateness of use among patients 12 to 45 years of age.METHODS: Asthmatic patients were interviewed about their asthma drug(s) use and the factors potentially associated with appropriateness of use according to the 2003 Canadian Asthma Consensus Conference guidelines. To determine the factors associated with the appropriate use of asthma drugs, a multivariate logistic regression model was built using a stepwise procedure, and ORs and associated 95% CIs were calculated.RESULTS: Of the 349 study participants, 43 (12.3%) reported appropriate use of their asthma drugs. Respondents who were more likely to report appropriate use were patients with sound knowledge of their asthma drugs (OR 2.61 [95% CI 1.29 to 5.29]), those in good, very good or excellent self-perceived health (OR 3.37 [95% CI 1.31 to 8.71]...
Factors Restrict Treatment Efficiency in Asthma Patients
International Journal of Medical and Biomedical Studies, 2021
Background: A number of modifiable factors that contribute to poor asthma control have been identified. We wanted to know how many patients had insufficient therapy, adherence, or major inhaler technique errors, and how they affected asthma control. Methodology: We conducted a cross-sectional multicenter observational research with asthma patients who were referred for the first time from primary to specialized treatment. Adequate prescription according to guidelines, treatment adherence, and illness control were among the data collected. 35.9% of the 1682 patients (age 45-17 years, 64.6 percent men) had insufficient prescriptions, 76.8% had low adherence, and 17 percent had critical inhaler technique errors, with Easyhaler users making significantly fewer critical errors than other dry powder inhaler users (10.3 versus 18.4%; p 0.05). Inadequate prescription (OR: 3.65), non-adherence to therapy (OR: 1.8), and inhaler abuse were all linked to poor asthma control (OR: 3.03). A greate...