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Rodríguez I, López-Caro JC, Gonzalez-Carranza S, Cerrato ME, De Prado MM, Gomez-Molleda F, Pinel M, Saiz MT, Fuentes C, Barreiro E, Santibáñez M. Adherence to inhaled corticosteroids in patients with asthma prior to and during the COVID-19 pandemic. Sci Rep 2023; 13:13086. [PMID: 37567951 PMCID: PMC10421941 DOI: 10.1038/s41598-023-40213-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 08/07/2023] [Indexed: 08/13/2023] Open
Abstract
The electronic prescription refill rate (EPRR) of 183 consecutive patients was determined over a 19-month retrospective study period, divided into 7 months PRE (Sep-19 to Mar-20) and 12 months POST pandemic (Apr-20 to Mar-21), in order to compare adherence to inhaled corticosteroids (ICS) in patients with asthma prior to and during the COVID-19 pandemic. Before the pandemic (PRE), an average of 0.58 inhalers/month were refill from the pharmacy; [SD 0.33], very similar to the 0.59 inhalers/month; [SD 0.34] retrieved during the 12 subsequent months since the pandemic (POST) (p = 0.768). EPRR showed no differences (p = 0.784). When EPRR was dichotomous or ordinal categorised no differences were found either (p = 0.851 and 0.928), even when McNemar's test was used (p = 0.949), with prevalences of nonadherence (EPRR < 80%) of 57 and 58% respectively. Our results do not support increased adherence to inhaler treatment in terms of EPRR, comparing before and since COVID-19 pandemic. Compliance with prescription remains suboptimal.
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Affiliation(s)
- Isabel Rodríguez
- Centro de Salud de los Corrales de Buelna, Servicio Cántabro de Salud, Los Corrales de Buelna, Spain
| | | | | | - Maria Elena Cerrato
- Centro de Salud La Corredoria, Servicio de Salud del Principado de Asturias, Oviedo, Spain
| | - Maria Mar De Prado
- Centro de Salud Basurto, Osakidetza-Servicio Vasco de Salud, Bilbao, Spain
| | | | - Margarita Pinel
- Centro de Salud La Habana-Cuba, Osakidetza-Servicio Vasco de Salud, Vitoria, Spain
| | | | - Carmen Fuentes
- Centro de Salud Cicero, Servicio Cántabro de Salud, Gama, Spain
| | - Esther Barreiro
- Pulmonology Department-Muscle Wasting and Cachexia in Chronic Respiratory Diseases and Lung Cancer, IMIM-Hospital del Mar, CEXS, Pompeu Fabra University, PRBB, Barcelona, Spain
- Centro de Investigación en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Barcelona, Spain
| | - Miguel Santibáñez
- Global Health Research Group, Dpto Enfermería, Universidad de Cantabria-Instituto de Investigación Marqués de Valdecilla (IDIVAL), Avda. Valdecilla, s/n., 39008, Santander, Cantabria, Spain.
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Takkinsatian P, Chantaratin S, Sirisakpanit S, Srisuwatchari W, Pacharn P, Jirapongsananuruk O, Visitsunthorn N. Psychosocial factors and lack of asthma knowledge undermine child and adolescent adherence to inhaled corticosteroid. J Asthma 2021; 59:2234-2245. [PMID: 34752204 DOI: 10.1080/02770903.2021.1999468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
This study aimed to evaluate inhaled corticosteroid (ICS) adherence and identify factors associated with non-adherence in pediatric asthma patients. A total of 134 patients aged 8-18 years old were included. At the first visit, patient adherence, asthma knowledge, and outcome expectation data were collected and recorded. Depression, anxiety, and self-esteem were assessed using psychiatric questionnaires. After providing asthma education, reevaluation of adherence and asthma control was performed at one 3- to 6-month follow-up visit. The mean ICS adherence was 75.9 ± 27.5%. Fifty-seven patients (42.5%) were defined as having poor adherence (<75%). "Intentional" and "hectic lifestyle and forgetfulness" were the main reasons for missing ICS doses in mid-late adolescents and children, respectively. Asthma knowledge generally improved with age. Overall, 89% and 67.7% of patients could define symptoms and triggers of asthma, respectively; however, less than 25% understood how asthma affected their body and the chronic nature of asthma. Patients with ICS adherence <75% had unfavorable expectations from asthma treatment (odds ratio [OR]: 1.05, 95% confidence interval [CI]: 1.01-1.10), and a higher proportion of inhaled short-acting beta-agonist use before exercise (OR: 4.12, 95% CI: 1.27-13.36). Depression and anxiety were frequently found (27.5%) and 23.3%, respectively; p > 0.05). Significant improvement in ICS adherence (p = 0.02) and Asthma Control Test scores (p = 0.02) were observed at the follow-up visit. Patient outcome expectations could be predictors of ICS adherence. Patient education regarding the mechanism and nature of asthma should be considered as an intervention for improving pediatric patient adherence. Psychological evaluation is warranted in pediatric patients with asthma.
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Affiliation(s)
- P Takkinsatian
- Division of Allergy and Immunology, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - S Chantaratin
- Division of Child and Adolescent Psychiatry, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - S Sirisakpanit
- Division of Child and Adolescent Psychiatry, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - W Srisuwatchari
- Division of Allergy and Immunology, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - P Pacharn
- Division of Allergy and Immunology, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - O Jirapongsananuruk
- Division of Allergy and Immunology, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - N Visitsunthorn
- Division of Allergy and Immunology, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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Rodriguez-Garcia C, Barreiro E, Muñoz-Gall X, Bustamante-Madariaga V, de-Granda-Orive I, Gonzalez-Barcala FJ. Common errors in inhalation therapy: Impact and solutions. CLINICAL RESPIRATORY JOURNAL 2020; 14:1001-1010. [PMID: 32710522 DOI: 10.1111/crj.13236] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 07/08/2020] [Accepted: 07/14/2020] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Inhalation therapy is one of the key pillars in the treatment of chronic obstructive diseases, such as asthma and COPD (Chronic obstructive pulmonary disease); however, wide number of errors occur with high frequency in the inhalation manoeuvres among these patient. This review discuss the main errors made with inhalation devices, factors associated with poor IT (inhalation technique), their consequences and possible solutions. DATA SOURCES To do this, we performed a search of any publications available in PubMed between the years 2000 and 2019, using the key words: asthma, COPD, obstructive lung disease, inhalers, misuse and errors. STUDY SELECTIONS After a review of the titles and abstracts by the working group, the articles chosen were considered the most relevant in providing evidence of the problems and establishing solutions in the inhalation treatment of asthma and COPD. RESULTS There are several publications that associated the errors in the inhalation technique with a poor prognosis both of asthma and COPD. Most authors generally agree in that a poor IT is associated with poor control of the symptoms. CONCLUSIONS It is essential to review the IT in all our patients with asthma and COPD due to the high socio-economic impact that it involves; an effort must be made to homogenise the evaluation of IT, so that it helps to transmit a clear message to the patients, as well as to the health professionals on what is and what is not a correct manoeuvre.
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Affiliation(s)
- Carlota Rodriguez-Garcia
- Pulmonology Department-Hospital, Universitario de Santiago de Compostela, Santiago de Compostela, Spain
| | - Esther Barreiro
- Pulmonology Department-Muscle Wasting and Cachexia in Chronic Respiratory Diseases and Lung Cancer Research Group, IMIM-Hospital del Mar, Parc de Salut Mar, Barcelona, Spain.,Health and Experimental Sciences Department (CEXS), Universitat Pompeu Fabra (UPF), Barcelona, Spain.,Centro de Investigación en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Xavier Muñoz-Gall
- Centro de Investigación en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.,Barcelona Biomedical Research Park (PRBB), Barcelona, Spain.,Pulmonology Department-Hospital, Universitario Vall d'Hebron, Barcelona, Spain.,Department of Cell Biology, Physiology, and Immunology, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Victor Bustamante-Madariaga
- Pneumology Department, Hospital Universitario Basurto, Osakidetza/University of the Basque Country, Bilbao, Spain
| | - Ignacio de-Granda-Orive
- Pulmonology Department, Hospital Universitario 12 de Octubre, Madrid, Spain.,Medicine Department, Universidad Complutense, Madrid, Spain
| | - Francisco-Javier Gonzalez-Barcala
- Internal Medicine Department, Universidad de Santiago de Compostela, Santiago de Compostela, Spain.,Inflammatory Diseases, Instituto de Investigaciones Sanitarias (IDIS) de Santiago de Compostela, Santiago de Compostela, Spain
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López-Lois B, González-Barcala FJ, Facal D. Application of mindfulness techniques in patients with asthma or COPD. J Asthma 2020; 58:1237-1246. [PMID: 32475186 DOI: 10.1080/02770903.2020.1776729] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVE Mindfulness is the ability to pay attention to the present moment without judgment. Mindfulness interventions have proved to be effective in improving the management of psychological symptoms of chronic patients. The objective of this work is to update the evidence about the effects of mindfulness interventions on psychological symptoms in patients with asthma and chronic obstructive pulmonary disease (COPD). METHODOLOGY Data sources were PubMed and PsycInfo. From a first set of 109 articles, 12 about mindfulness-interventions in adult populations with asthma or COPD were finally included in the review. RESULTS Of the total of 12 studies included, 5 were qualitative and 6 quantitative (5 randomized controlled trials). One quantitative study reported long-term psychological effects in asthma patients, two studies reported short-term psychological effects in COPD patients. Relevant themes identified in qualitative studies included increased awareness, development of new relationships with dyspnea, including new cognitive strategies, and slowing down. CONCLUSIONS Mindfulness interventions could increase psychological resources in situations related to asthma and COPD symptoms. More randomized control trials are needed.
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Affiliation(s)
- Begoña López-Lois
- Departamento de Psicoloxía Evolutiva, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - Francisco-Javier González-Barcala
- Department of Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain.,Spanish Biomedical Research Networking Centre-CIBERES, Madrid, Spain.,Department of Respiratory Medicine, University Hospital of Santiago de Compostela, Santiago de Compostela, Spain.,Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - David Facal
- Departamento de Psicoloxía Evolutiva, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
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Asthma Control: A Continuing Challenge. OPEN RESPIRATORY ARCHIVES 2020. [DOI: 10.1016/j.opresp.2019.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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