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Liu Z, Dai H, Tao F, He X, Jin T. Guardian's knowledge and attitude towards inhaled corticosteroids aerosol therapy and medication compliance of children with wheezing diseases. ALLERGY, ASTHMA, AND CLINICAL IMMUNOLOGY : OFFICIAL JOURNAL OF THE CANADIAN SOCIETY OF ALLERGY AND CLINICAL IMMUNOLOGY 2024; 20:42. [PMID: 39049039 PMCID: PMC11271035 DOI: 10.1186/s13223-024-00908-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 07/15/2024] [Indexed: 07/27/2024]
Abstract
BACKGROUND Glucocorticoids are widely used in inhalation aerosol therapy for wheezing diseases. This study aims to explore guardians' knowledge and attitude towards inhaled corticosteroids (ICS) aerosol therapy and the medication compliance of children with wheezing diseases in China. METHODS This cross-sectional study enrolled guardians of children with wheezing diseases at the First Hospital Affiliated to Shaoyang College between October 2022 and February 2023. A self-administered questionnaire was developed to collect demographic information of the participants and evaluate their knowledge and attitude towards ICS aerosol therapy. The 8-item Morisky Medication Adherence Scale was used to assess the medication compliance of children. RESULTS A total of 506 valid questionnaires were collected. 260 (51.38%) participants were guardians of a ≤ 3-year-old child and 327 (64.62%) were children's mothers. The knowledge, attitude, and medication compliance scores of all participants were 12.61 ± 5.78, 20.95 ± 2.37, and 4.69 ± 2.18, respectively. Multivariate logistic regression showed that knowledge scores [OR = 1.053, 95% CI (confidence interval): 1.017-1.090, P = 0.003], attitude scores (OR = 1.121, 95% CI: 1.030-1.219, P = 0.008), guardians of children aged 4-6 years (OR = 0.385, 95% CI: 0.242-0.612, P < 0.001), and grandparents of children (OR = 2.633, 95% CI: 1.104-6.275, P = 0.029) were independently associated with children's medication compliance. CONCLUSIONS In conclusion, guardians of children with wheezing diseases in China had insufficient knowledge, unsatisfactory attitude, and poor medication compliance towards ICS aerosol therapy. TRIAL REGISTRATION Retrospectively registered.
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Affiliation(s)
- Zuojiao Liu
- The First Affiliated Hospital of Shaoyang University, Shaoyang, 422003, China
| | - Haiqing Dai
- The First Affiliated Hospital of Shaoyang University, Shaoyang, 422003, China.
| | - Fengjiao Tao
- The First Affiliated Hospital of Shaoyang University, Shaoyang, 422003, China
| | - Xiaoxiao He
- The First Affiliated Hospital of Shaoyang University, Shaoyang, 422003, China
| | - Ting Jin
- The First Affiliated Hospital of Shaoyang University, Shaoyang, 422003, China
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Kotry D, Saillard J, Bonsergent M, Volteau C, Benichou A, Prot-Labarthe S, Huon JF. Observational and prospective study: evaluation of beliefs and representations of chronic treatments of polymedicated patients hospitalised in a vascular medicine and surgery department. BMJ Open 2023; 13:e073250. [PMID: 38097247 PMCID: PMC10729245 DOI: 10.1136/bmjopen-2023-073250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 10/24/2023] [Indexed: 12/18/2023] Open
Abstract
OBJECTIVES Today, the involvement of patients in their care is essential. As the population ages increases, the number of patients with chronic diseases is increasing. In the vascular medicine and surgery departments, patients are polymedicated and mostly suffer from several chronic diseases. Approximately 50% of patients with a chronic disease are not adherent. Among the factors that can influence therapeutic adherence are the beliefs and representations of patients.To evaluate the beliefs and representations of chronic treatments in patients with multiple medications and hospitalised in a vascular medicine and surgery department, and to evaluate the medication adherence, the knowledge and the importance patients attach to their treatments. DESIGN Observational, prospective and a single-centre study. SETTING The study was conducted in a French tertiary hospital centre of around 3000 beds in 9 institutions. PARTICIPANTS Adult polymedicated (ie, minimum of five chronic treatments) patients hospitalised in a vascular medicine and surgery department were included after application of the exclusion criteria. METHODS Patient interviews were carried out in the department and were based on three interviewer-administered questionnaires (a global questionnaire, the Belief Medical Questionnaire and the GIRERD questionnaire). RESULTS Our study showed that patients perceived their treatments as beneficial rather than worrying. A correlation between medication adherence and beliefs was observed. 'Non-adherent'patients had a more negative overall view of medication than 'adherent' patients. The level of compliance and knowledge of our patients was low. Only 11% of the patients were 'good adherent', 16% of the patients could perfectly name their treatment and 36% knew all the indications. CONCLUSION Knowledge of treatment representation and beliefs are central to understanding patient behaviour. Considering patients' representations will allow the identification of levers, and the development of actions and educational tools adapted to improve their adherence, their knowledge and therefore their drug management.
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Affiliation(s)
- Dounia Kotry
- Nantes Université, CHU Nantes, Pharmacie, F-44000, France
| | | | | | - Christelle Volteau
- Nantes Université, CHU Nantes, DRCI, Département Promotion, Nantes, Cedex, France
| | - Antoine Benichou
- Nantes Université, CHU Nantes, Médecine Interne, F-44000, France
| | - Sonia Prot-Labarthe
- Nantes Université, CHU Nantes, Pharmacie, F-44000, France
- Nantes Université, CHU Nantes, F-44000, Pharmacie, France
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Jébrak G, Houdouin V, Terrioux P, Lambert N, Maitre B, Ruppert AM. [Therapeutic adherence among asthma patients: Variations according to age groups. How can it be improved? The potential contributions of new technologies]. Rev Mal Respir 2022; 39:442-454. [PMID: 35597725 DOI: 10.1016/j.rmr.2022.01.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 01/11/2022] [Indexed: 11/28/2022]
Abstract
While asthma patients' treatment adherence (TA) generally leaves to be desired, few data exist on TA evolution from age group to another. During the meeting of a working group of pneumo-pediatricians and adult pulmonologists, we reviewed the literature on adherence according to age group, examined explanations for poor adherence, and explored ways of improving adherence via new technologies. Asthma is a chronic disease for which TA is particularly low, especially during adolescence, but also among adults. Inhaled medications are the least effectively taken. Several explanations have been put forward: cost and complexity of treatments, difficulties using inhalation devices, poor understanding of their benefits, erroneous beliefs and underestimation of the severity of a fluctuating disease, fear of side effects, neglect, and denial (especially among teenagers). Poor TA is associated with risks of needless treatment escalation, aggravated asthma with frequent exacerbations, increased school absenteeism, degraded quality of life, and excessive mortality. Better compliance is based on satisfactory relationships between caregivers and asthmatics, improved caregiver training, and more efficient transmission to patients of relevant information. The recent evolution of innovative digital technologies opens the way for enhanced communication, via networks and dedicated applications, and thanks to connected inhalation devices, forgetfulness can be limited. Clinical research will also help to ameliorate TA. Lastly, it bears mentioning that analysis of the existing literature is hampered by differences in terms of working definitions and means of TA measurement.
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Affiliation(s)
- G Jébrak
- Service de pneumologie B et de transplantations pulmonaires, hôpital Bichat, Paris, France.
| | - V Houdouin
- Service de pneumologie, allergologie et CRCM pédiatrique, hôpital Robert-Debré, Paris, France
| | - P Terrioux
- Cabinet libéral de pneumologie, Meaux, France
| | - N Lambert
- Service d'allergologie (centre de l'asthme et des allergies), Hôpital A. Trousseau, Paris, France
| | - B Maitre
- Service de pneumologie, centre hospitalier intercommunal de Créteil, université Paris Est Créteil, Créteil, France
| | - A-M Ruppert
- Service de pneumologie, UF tabacologie, hôpital Tenon, DMU APPROCHES, Paris, France
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Román Rodríguez M, Ginel Mendoza L, Blanco Aparicio M, Rodríguez Rodríguez M, Bárcena Caamaño M. [What not to do in the therapeutic management of bronchial asthma. Delphi consensus recommendations for physicians who treat asthma]. Aten Primaria 2021; 53:102101. [PMID: 34029773 PMCID: PMC8165326 DOI: 10.1016/j.aprim.2021.102101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 03/30/2021] [Accepted: 03/31/2021] [Indexed: 11/25/2022] Open
Abstract
Asthma is one of the most prevalent diseases in Spain, yet despite the great diagnostic and therapeutic advances made in this field, health outcomes suggest that up to 80% of patients do not have their asthma well controlled. Although the causes of this situation are diverse, there are some practices among the professionals who treat asthma that are not conducive to improving health outcomes in this disease. Our working group has prepared this document in order to remind clinicians of a series of basic guidelines, aligned with current guidelines and recent literature, and agreed by a multidisciplinary expert panel using Delphi methodology. These recommendations about what not to do in the management of asthma in the adult patient are structured into four areas: diagnosis, monitoring, treatment and prevention of exacerbations.
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Affiliation(s)
- Miguel Román Rodríguez
- Medicina de familia y Comunitaria, Centro de salud Son Pisá, Palma Instituto de Investigación Sanitaria de Baleares (IdISBa), Palma, España
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Cai Q, Ye L, Horne R, Ye X, Xu Q, Jin M, Li X, Lyu Q. Medication adherence in adult Chinese patients with asthma: role of illness perceptions and medication beliefs. J Asthma 2021; 59:1445-1451. [PMID: 33941026 DOI: 10.1080/02770903.2021.1924773] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE This study aimed to investigate the relationship between illness perceptions, medication beliefs, and self-reported adherence to inhaled corticosteroid (ICS) therapy in adult Chinese patients with asthma. METHODS A cross-sectional survey was conducted in the asthma outpatient clinic of Zhongshan Hospital, Fudan University (Shanghai, China) between October 2018 and September 2019. Illness perceptions, medication beliefs, and medication adherence were assessed using validated scales, specifically the Medication Adherence Report Scale for Asthma, Beliefs about Medicines Questionnaire -Specific, and the Brief Illness Perception Questionnaire. Spearman correlation and multiple logistic regression were used to determine the relationship among these factors. Results: A total of 234 patients were included in this study. Of this group, 99 (42.3%) participants were non-adherent to their ICS medication. Medication adherence correlated negatively with 'illness identity' (perceived symptom), 'emotional response' (perceived emotional effect) and concerns about medication (r=-0.16, -0.16 and -0.15, respectively, p < 0.05). After adjusting for illness perceptions, medication beliefs and demographics, beliefs about the necessity of medication (odds ratio [OR]: 1.14, 95% confidence interval [CI]: 1.01-1.30), and emotional response to the disease (OR: 0.89, 95% CI: 0.80-0.99) were significantly associated with medication adherence in patients with asthma. CONCLUSION Beliefs about the necessity of medication and emotional response to the illness have a strong influence on self-reported medication adherence in adult patients with asthma in China. Interventions targeted adherence improvement among patients with asthma may be tailored to the individual's baseline perceptions and medication beliefs, and focus on modifying inaccurate illness perceptions and medication beliefs as the main targets.
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Affiliation(s)
- Qingqing Cai
- Department of Pharmacy, Zhongshan Hospital, Fudan University, Shanghai, PR China
| | - Ling Ye
- Department of Respiratory, Zhongshan Hospital, Fudan University, Shanghai, PR China
| | - Robert Horne
- School of Pharmacy, University College London, London, UK
| | - Xiaofen Ye
- Department of Pharmacy, Zhongshan Hospital, Fudan University, Shanghai, PR China
| | - Qing Xu
- Department of Pharmacy, Zhongshan Hospital, Fudan University, Shanghai, PR China
| | - Meiling Jin
- Department of Respiratory, Zhongshan Hospital, Fudan University, Shanghai, PR China
| | - Xiaoyu Li
- Department of Pharmacy, Zhongshan Hospital, Fudan University, Shanghai, PR China
| | - Qianzhou Lyu
- Department of Pharmacy, Zhongshan Hospital, Fudan University, Shanghai, PR China
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Aberhe W, Hailay A, Zereabruk K, Mebrahtom G, Haile T. Non-adherence to inhaled medications among adult asthmatic patients in Ethiopia: a systematic review and meta-analysis. Asthma Res Pract 2020; 6:12. [PMID: 33072392 PMCID: PMC7556918 DOI: 10.1186/s40733-020-00065-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 10/05/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Medication non-adherence is one of a common problem in asthma management and it is the main factor for uncontrolled asthma. It can result in poor asthma control, which leads to decreased quality of life, increase hospital admission, increased health care utilization, lost productivity, and mortality. To date, there have been no studies and protocols that estimated the pooled national prevalence of non-adherence to inhaled anti-asthmatic medications in Ethiopia. Therefore, the primary purpose of this systematic review and meta-analysis is to determine the pooled national prevalence of non-adherence to inhaled medications among asthmatic patients in Ethiopia. METHODS Different database searching engines including PubMed, Scopus, Google Scholar, Africa journal online, World Health Organization afro library, and Cochrane review were systematically searched by using keywords such as "prevalence, non-adherence to inhaled medications, inhaled corticosteroids, and asthmatic patients" and their combinations. Six published observational studies that report the prevalence of non-adherence to inhaled medications were finally selected. The Preferred Reporting Items for Systematic Review and Meta-Analysis guideline was followed. Heterogeneity across the included studies was evaluated by the inconsistency index (I2). The random-effect model was fitted to estimate the pooled prevalence of non-adherence to inhale anti-asthmatic medications. All statistical analysis was done using R version 3.5.3 and R Studio version 1.2.5033 software for windows. RESULTS The pooled national prevalence of non-adherence to inhaled medications among asthmatic patients was 29.95% (95% CI, 19.1, 40.8%). The result of this meta-analysis using the random-effects model revealed that there is high heterogeneity across the included studies. The result of subgroup analysis indicates that one out of three in the Oromia region and one out of five in the Amhara region asthmatic patients was non-adherent to their inhaled anti-asthmatic medications. CONCLUSION the prevalence of non-adherence to inhaled anti-asthmatic medications was high. Thus, our finding suggests that one out of four asthmatic patients were non-adherent to inhaled medications. The ministry of health, health policymakers, clinicians, and other health care providers should pay attention to strengthening the adherence levels to inhaled anti-asthmatic medications, and country-based interventions should be developed to reduce the burden of non-adherence to inhaled anti-asthmatic medications.
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Affiliation(s)
- Woldu Aberhe
- Department of Adult Health Nursing, School of Nursing, Aksum University, Aksum, Ethiopia
| | - Abrha Hailay
- Department of Adult Health Nursing, School of Nursing, Aksum University, Aksum, Ethiopia
| | - Kidane Zereabruk
- Department of Adult Health Nursing, School of Nursing, Aksum University, Aksum, Ethiopia
| | - Guesh Mebrahtom
- Department of Adult Health Nursing, School of Nursing, Aksum University, Aksum, Ethiopia
| | - Teklehaimanot Haile
- Department of Maternity and Neonatal Nursing, School of Nursing, Aksum University, Aksum, Ethiopia
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7
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Laforest L, Belhassen M, Devouassoux G, Didier A, Letrilliart L, Van Ganse É. [Therapeutic adherence in asthma in France: A general review]. Rev Mal Respir 2017; 34:194-222. [PMID: 28359651 DOI: 10.1016/j.rmr.2016.03.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Accepted: 03/08/2016] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Adherence in asthma is a paramount issue of disease management. A general review of the French publications on this topic has been conducted. METHODS Research equations used for bibliographic databases (MEDLINE, Science Direct, Banque de données en santé publique, Cochrane and Cairn.info) comprised the following keywords: "asthma", "therapeutic adherence" and "France". These publications unrelated to asthma, focused on asthma management without exploring adherence, or those conducted in populations without French patients were excluded. RESULTS A total of 82 articles have been selected (36 surveys, 4 randomized trials and 42 reviews/syntheses). Whatever the methodology used and publication year, the inadequate therapeutic adherence in asthma was steadily reported, notably for controllers and the quality of use of inhaled devices. CONCLUSION The present review highlights the sustainability of adherence-related issues in asthma and the need to improve patients' knowledge on asthma and the finality of therapy. It also highlights the need of an improved communication between patients and physicians is also advocated. Further studies with more recent data are desirable to assess changes in disease management of asthma and the impact of potential future corrective interventions.
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Affiliation(s)
- L Laforest
- PELyon (Pharmacoepidemiology Lyon), faculté d'odontologie, 11, rue Guillaume Paradin, 69008 Lyon, France
| | - M Belhassen
- PELyon (Pharmacoepidemiology Lyon), faculté d'odontologie, 11, rue Guillaume Paradin, 69008 Lyon, France
| | - G Devouassoux
- Service de pneumologie, hôpital de la Croix-Rousse, hospices civils de Lyon, 69000, Lyon, France
| | - A Didier
- Pôle des voies respiratoires, hôpital Larrey, CHU de Toulouse, 31000, Toulouse, France
| | - L Letrilliart
- Département de médecine générale, faculté de médecine, université Claude-Bernard Lyon I, 69000, Lyon, France
| | - É Van Ganse
- PELyon (Pharmacoepidemiology Lyon), faculté d'odontologie, 11, rue Guillaume Paradin, 69008 Lyon, France; Service de pneumologie, hôpital de la Croix-Rousse, hospices civils de Lyon, 69000, Lyon, France; HESPER 7425, Health Services and Performance Research, Lyon, France.
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8
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Dima AL, de Bruin M, Van Ganse E. Mapping the Asthma Care Process: Implications for Research and Practice. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2016; 4:868-76. [PMID: 27283052 DOI: 10.1016/j.jaip.2016.04.020] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Revised: 04/27/2016] [Accepted: 04/29/2016] [Indexed: 12/25/2022]
Abstract
BACKGROUND Whether people with asthma gain and maintain control over their condition depends not only on the availability of effective drugs, but also on multiple patient and health care professional (HCP) behaviors. Research in asthma rarely considers how these behaviors interact with each other and drug effectiveness to determine health outcomes, which may limit real-life applicability of findings. OBJECTIVE The objective of this study was to develop a logic process model (Asthma Care Model; ACM) that explains how patient and HCP behaviors impact on the asthma care process. METHODS Within a European research project on asthma (ASTRO-LAB), we reviewed asthma care guidelines and empirical literature, and conducted qualitative interviews with patients and HCPs. Findings were discussed with the project team and respiratory care experts and integrated in a causal model. RESULTS The model outlines a causal sequence of treatment events, from diagnosis and assessment to treatment prescription, drug exposure, and health outcomes. The relationships between these components are moderated by patient behaviors (medication adherence, symptom monitoring, managing triggers, and exacerbations) and HCP behaviors (medical care and self-management support). Modifiable and nonmodifiable behavioral determinants influence the behaviors of patients and HCPs. The model is dynamic as it includes feedback loops of behavioral and clinical outcomes, which influence future patient and HCP decision making. Key evidence for each relationship is summarized to derive research priorities and clinical recommendations. CONCLUSIONS The ACM model is of interest to both researchers and practitioners, and intended as a first version (ACM-v1) of a common framework for generating and translating research evidence in asthma care.
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Affiliation(s)
- Alexandra Lelia Dima
- Amsterdam School of Communication Research ASCoR, University of Amsterdam, Amsterdam, the Netherlands.
| | - Marijn de Bruin
- Amsterdam School of Communication Research ASCoR, University of Amsterdam, Amsterdam, the Netherlands; Institute of Applied Health Sciences, University of Aberdeen, Foresterhill, Aberdeen, Scotland
| | - Eric Van Ganse
- Lyon Pharmaco-Epidemiology Unit, Faculte d'Odontologie, Universite Claude Bernard Lyon 1, Lyon, France; Respiratory Medicine, Croix-Rousse University Hospital, Lyon, France
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Towards tailored and targeted adherence assessment to optimise asthma management. NPJ Prim Care Respir Med 2015; 25:15046. [PMID: 26181850 PMCID: PMC4588030 DOI: 10.1038/npjpcrm.2015.46] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2014] [Revised: 05/31/2015] [Accepted: 06/01/2015] [Indexed: 01/28/2023] Open
Abstract
In this paper, we aim to emphasise the need for a more comprehensive and tailored approach to manage the broad nature of non-adherence, to personalise current asthma management. Although currently several methods are available to measure the extent of asthma patients' adherence, the vast majority do not incorporate confirmation of the actual inhalation, dose and inhalation technique. Moreover, most current measures lack detailed information on the individual consequences of non-adherence and on when and how to take action if non-adherence is identified. Notably, one has to realise there are several forms of non-adherence (erratic non-adherence, intelligent non-adherence and unwitting non-adherence), each requiring a different approach. To improve asthma management, more accurate methods are needed that integrate measures of non-adherence, asthma disease control and patient preferences. Integrating information from the latest inhaler devices and patient-reported outcomes using mobile monitoring- and feedback systems ('mHealth') is considered a promising strategy, but requires careful implementation. Key issues to be considered before large-scale implementation include patient preferences, large heterogeneity in patient and disease characteristics, economic consequences, and long-term persistence with new digital technologies.
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Dima AL, Hernandez G, Cunillera O, Ferrer M, de Bruin M. Asthma inhaler adherence determinants in adults: systematic review of observational data. Eur Respir J 2014; 45:994-1018. [PMID: 25504997 DOI: 10.1183/09031936.00172114] [Citation(s) in RCA: 100] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Nonadherence to inhaled medication leads to poor asthma control and increased healthcare utilisation. Many studies exploring adherence determinants have been conducted, but summaries of the evidence are scarce. We performed a systematic review of observational research on determinants of asthma inhaler adherence among adults. We searched for articles in English reporting quantitative observational studies on inhaler adherence correlates among adults in developed countries, published in EMBASE, Medline, PsychInfo and PsychArticles in 1990-2014. Two coders independently assessed eligibility and extracted data, and assessed study quality. Results were summarised qualitatively into social and economic, and healthcare-, therapy-, condition- and patient-related factors. The 51 studies included mainly examined patient-related factors and found consistent links between adherence and stronger inhaler-necessity beliefs, and possibly older age. There was limited evidence on the relevance of other determinants, partly due to study heterogeneity regarding the types of determinants examined. Methodological quality varied considerably and studies performed generally poorly on their definitions of variables and measures, risk of bias, sample size and data analysis. A broader adoption of common methodological standards and health behaviour theories is needed before cumulative science on the determinants of adherence to asthma inhalers among adults can develop further.
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Affiliation(s)
- Alexandra L Dima
- Dept of Communication Science, ASCoR, University of Amsterdam, Amsterdam, The Netherlands.
| | - Gimena Hernandez
- Health Services Research Unit, IMIM (Hospital del Mar Research Institute), Barcelona, Spain. Dept of Paediatrics, Obstetrics and Gynaecology and Preventative Medicine, Universitat Autónoma de Barcelona, Barcelona, Spain
| | - Oriol Cunillera
- Health Services Research Unit, IMIM (Hospital del Mar Research Institute), Barcelona, Spain
| | - Montserrat Ferrer
- Health Services Research Unit, IMIM (Hospital del Mar Research Institute), Barcelona, Spain. Dept of Paediatrics, Obstetrics and Gynaecology and Preventative Medicine, Universitat Autónoma de Barcelona, Barcelona, Spain
| | - Marijn de Bruin
- Dept of Communication Science, ASCoR, University of Amsterdam, Amsterdam, The Netherlands. Aberdeen Health Psychology Group, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
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Devillier P, Salvator H, Roche N. [The choice of inhalation device: A medical act]. Rev Mal Respir 2014; 32:599-607. [PMID: 25433462 DOI: 10.1016/j.rmr.2014.10.729] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Accepted: 10/19/2014] [Indexed: 11/26/2022]
Abstract
Inhaled treatments are essential for respiratory diseases management, including COPD and asthma. Optimal control of the disease largely depends on patient's compliance and proper use of these treatments. Different types of ready-to-use inhaler devices are available: metered dose inhaler, dry powder inhaler or soft mist inhaler. Each of these devices presents specific characteristics and constraints that have to be evaluated and taken into account before prescription. In order to optimize adherence and treatment efficacy, the choice of inhaler device should depend on the specific needs, abilities and preferences of each patient and a specific education to treatment should be provided. Inhaled treatments, even containing the same drug, have different technical constraints and are thus not easily interchangeable. Their substitution without prior medical consent and without proper training can lead to errors in taking treatment, treatment failures and increased health care consumption. In France, substitution by the pharmacist is not authorized. While patient education must be carried out in collaboration with all health professionals, it is preferable that the choice of inhaler device remains the responsibility of the physician.
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Affiliation(s)
- P Devillier
- UPRES EA 220 & délégation à la recherche clinique et à l'innovation, pôle des maladies respiratoires, faculté de médecine Paris-Ouest, hôpital Foch, 11, rue Guillaume-Lenoir, 92150 Suresnes, France.
| | - H Salvator
- UPRES EA 220 & délégation à la recherche clinique et à l'innovation, pôle des maladies respiratoires, faculté de médecine Paris-Ouest, hôpital Foch, 11, rue Guillaume-Lenoir, 92150 Suresnes, France
| | - N Roche
- Service de pneumologie et soins intensifs respiratoires, groupe hospitalier Cochin, université Paris Descartes (EA2511), HIA du Val-de-Grâce, 75005 Paris, France
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Olszanecka-Glinianowicz M, Almgren-Rachtan A. The adherence and illness perception of patients diagnosed with asthma or chronic obstructive pulmonary disease treated with polytherapy using new generation Cyclohaler. Postepy Dermatol Alergol 2014; 31:235-46. [PMID: 25254009 PMCID: PMC4171677 DOI: 10.5114/pdia.2014.45070] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2014] [Revised: 08/25/2014] [Accepted: 08/27/2014] [Indexed: 01/22/2023] Open
Abstract
INTRODUCTION The factors influencing adherence of patients diagnosed with asthma and chronic obstructive pulmonary disease (COPD) include the complexity of the therapy, fear of side effects of drugs, method of taking the drug, dosage regimen, polypharmacy, adverse events, knowledge about the essence of the disease and its complications, illness perception and priorities in life, training on the use of the inhaler, the duration of treatment, social support, and drug availability. AIM To assess the adherence of patients diagnosed with asthma and COPD treated with polytherapy with fluticasone propionate and formoterol fumarate using the Fantasmino inhaler in relation to primary diagnosis and illness perception as well as patients' and doctors' opinion about this form of therapy. MATERIAL AND METHODS A questionnaire survey covering adherence, illness perception and opinion about polytherapy using new generation Cyclohaler performed by pulmonologists, allergologists and general practitioners in 3,618 patients with asthma and 2,602 with COPD. RESULTS On visit 1, a lower adherence rate was observed in COPD than in the asthma group (72.0% vs. 61.5%; p < 0.01). During the observation, the adherence rate increased significantly in the COPD group, only (61.5% vs. 73.0%; p < 0.01). A negative correlation between total MMAS-8 and BIPQ scores was observed in both study groups (R = -0.15; p < 0.001 and R = -0.24; p < 0.001, respectively). During the observation, a percentage of patients who believed that the administration of the two drugs in a single inhaler considerably facilitates their use increased significantly in both study groups. In addition, an increased percentage of doctors believed that this therapeutic option facilitated education of patients and decreased the number of errors made by the patients. CONCLUSIONS The illness perception, younger age, disease duration and severity are predictors of adherence to treatment with fluticasone propionate and formoterol fumarate using the Fantasmino inhaler among patients with asthma and COPD. The positive opinion of patients and doctors about administration of fluticasone propionate and formoterol fumarate using the Fantasmino inhaler increased during observation.
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Affiliation(s)
- Magdalena Olszanecka-Glinianowicz
- Health Promotion and Obesity Management Unit, Department of Pathophysiology, Medical Faculty in Katowice, Medical University of Silesia. Head of the Unit: Prof. Magdalena Olszanecka-Glinianowicz MD, PhD
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Long-term systemic glucocorticoid therapy: Patients’ representations, prescribers’ perceptions, and treatment adherence. Joint Bone Spine 2014; 81:64-8. [DOI: 10.1016/j.jbspin.2013.07.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/15/2013] [Indexed: 11/22/2022]
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