Influence of Adherence to Inhaled Corticosteroids and Inhaler Handling Errors on Asthma Control in a Japanese Population

Overview

Journal Intern Med

Specialty General Medicine

Date 2018 Aug 14

PMID 30101909

Citations 6

Authors

Toshiyuki Koya

Takashi Hasegawa

Junko Takasawa

Fumitoshi Yoshimine

Takuro Sakagami

Masachika Hayashi

Eiichi Suzuki

Toshiaki Kikuchi

Affiliations

Soon will be listed here.

Abstract

Objective High adherence to medications and accurate handling of inhaler devices are important for asthma management. However, few reports to date have simultaneously evaluated adherence and handling errors. We therefore investigated the adherence to inhaled corticosteroid (ICS) and inhaler handling errors in the same patients in cooperation with pharmacists. Methods Data were derived from a survey of physicians and pharmacists treating asthma patients who visited participating hospitals and pharmacies from July 2012 to January 2013. The patients were evaluated for asthma control using the Asthma Control Test (ACT) and for inhaler handling errors using checklists. ICS adherence was evaluated based on pharmaceutical records. Results Adherence among participants (n=290) was 33.3% (mean), and the percentage of inhaler handling errors was 20.0% (mean). Total inhalation times in the high-adherence group were fewer than those in the low-adherence group. In a comparison by device, adherence to pressurized metered dose inhalers was significantly lower than that to Diskus inhalers, presumably attributable to the total number of inhalations per day. Adherence, handling errors, and total number of inhalations per day were significantly different between the asthma-controlled group and the uncontrolled group. A multivariate analysis showed that adherence and handling errors were independent factors contributing to asthma control. Conclusion Our data indicated that both adherence to ICS and device handling errors contributed to asthma control in this population.

Citing Articles

Effect of illness perceptions on asthma control and quality of life amongst adult outpatients with asthma in China.

Cai Q, Jin M, Li X, Zhang J, Xu Q, Ye L BMC Psychol. 2023; 11(1):68.

PMID: 36907916 PMC: 10009986. DOI: 10.1186/s40359-023-01097-3.

Association Between Patient Preference for Inhaler Medications and Asthma Outcomes.

Nakanishi Y, Iwamoto H, Miyamoto S, Nakao S, Higaki N, Yamaguchi K J Asthma Allergy. 2022; 15:1539-1547.

PMID: 36316999 PMC: 9617517. DOI: 10.2147/JAA.S381509.

Improved inhaler handling after repeated inhalation guidance for elderly patients with bronchial asthma and chronic obstructive pulmonary disease.

Usami O Medicine (Baltimore). 2022; 101(35):e30238.

PMID: 36107520 PMC: 9439803. DOI: 10.1097/MD.0000000000030238.

Drug-handling problems and expectations of the ideal pediatric drug-reported by children and their parents.

Herziger B, Jeschke S, Muller R, Neininger M, Bertsche T, Bertsche A Eur J Pediatr. 2022; 181(5):2161-2171.

PMID: 35199240 PMC: 9056485. DOI: 10.1007/s00431-022-04419-6.

Inhaler Technique and Self-reported Adherence to Medications Among Hospitalised People with Asthma and COPD.

Elander A, Gustafsson M Drugs Real World Outcomes. 2020; 7(4):317-323.

PMID: 33052539 PMC: 7581666. DOI: 10.1007/s40801-020-00210-x.

References

Chrystyn H, Price D, Molimard M, Haughney J, Bosnic-Anticevich S, Lavorini F . Comparison of serious inhaler technique errors made by device-naïve patients using three different dry powder inhalers: a randomised, crossover, open-label study. BMC Pulm Med. 2016; 16:12. PMC: 4712500. DOI: 10.1186/s12890-016-0169-5. View

Williams L, Joseph C, Peterson E, Moon C, Xi H, Krajenta R . Race-ethnicity, crime, and other factors associated with adherence to inhaled corticosteroids. J Allergy Clin Immunol. 2007; 119(1):168-75. DOI: 10.1016/j.jaci.2006.09.029. View

Wells K, Pladevall M, Peterson E, Campbell J, Wang M, Lanfear D . Race-ethnic differences in factors associated with inhaled steroid adherence among adults with asthma. Am J Respir Crit Care Med. 2008; 178(12):1194-201. PMC: 2599867. DOI: 10.1164/rccm.200808-1233OC. View

Kelloway J, Wyatt R, Adlis S . Comparison of patients' compliance with prescribed oral and inhaled asthma medications. Arch Intern Med. 1994; 154(12):1349-52. View

Wieshammer S, Dreyhaupt J . Dry powder inhalers: which factors determine the frequency of handling errors?. Respiration. 2007; 75(1):18-25. DOI: 10.1159/000109374. View

van Schayck C, Folgering H, Cloosterman S, Akkermans R, van den Elshout F, van Weel C . Influence of two different inhalation devices on therapy compliance in asthmatic patients. Scand J Prim Health Care. 2002; 20(2):126-8. DOI: 10.1080/pri.20.2.126.128. View

Hasegawa T, Koya T, Sakagami T, Toyabe S, Kagamu H, Arakawa M . Asthma control and management changes in Japan: questionnaire survey. Intern Med. 2012; 51(6):567-74. DOI: 10.2169/internalmedicine.51.6586. View

Gibson P, McDonald V, Marks G . Asthma in older adults. Lancet. 2010; 376(9743):803-13. DOI: 10.1016/S0140-6736(10)61087-2. View

Stern L, Berman J, Lumry W, Katz L, Wang L, Rosenblatt L . Medication compliance and disease exacerbation in patients with asthma: a retrospective study of managed care data. Ann Allergy Asthma Immunol. 2006; 97(3):402-8. DOI: 10.1016/S1081-1206(10)60808-3. View

10.

Price D, Roman-Rodriguez M, McQueen R, Bosnic-Anticevich S, Carter V, Gruffydd-Jones K . Inhaler Errors in the CRITIKAL Study: Type, Frequency, and Association with Asthma Outcomes. J Allergy Clin Immunol Pract. 2017; 5(4):1071-1081.e9. DOI: 10.1016/j.jaip.2017.01.004. View

11.

Griffith S . A review of the factors associated with patient compliance and the taking of prescribed medicines. Br J Gen Pract. 1990; 40(332):114-6. PMC: 1371078. View

12.

Molimard M, Le Gros V . Impact of patient-related factors on asthma control. J Asthma. 2008; 45(2):109-13. DOI: 10.1080/02770900701815727. View

13.

Dal Negro R, Povero M . The economic impact of educational training assessed by the Handling Questionnaire with three inhalation devices in asthma and Chronic Obstructive Pulmonary Disease patients. Clinicoecon Outcomes Res. 2016; 8:171-6. PMC: 4869654. DOI: 10.2147/CEOR.S104066. View

14.

Melani A, Bonavia M, Cilenti V, Cinti C, Lodi M, Martucci P . Inhaler mishandling remains common in real life and is associated with reduced disease control. Respir Med. 2011; 105(6):930-8. DOI: 10.1016/j.rmed.2011.01.005. View

15.

Hasegawa T, Koya T, Sakagami T, Kagamu H, Arakawa M, Gejyo F . The Asthma Control Test, Japanese Version (ACT-J) as a Predictor of Global Initiative for Asthma (GINA) Guideline-Defined Asthma Control: Analysis of a Questionnaire-Based Survey. Allergol Int. 2017; 62(3):323-330. DOI: 10.2332/allergolint.13-OA-0535. View

16.

Williams L, Peterson E, Wells K, Ahmedani B, Kumar R, Burchard E . Quantifying the proportion of severe asthma exacerbations attributable to inhaled corticosteroid nonadherence. J Allergy Clin Immunol. 2011; 128(6):1185-1191.e2. PMC: 3229671. DOI: 10.1016/j.jaci.2011.09.011. View

17.

Suzuki T, Hasegawa T, Suzuki E, Sasahara K, Kawada T, Koya T . Efficacy of fluticasone propionate compared with beclomethasone dipropionate in bronchial asthma: improvement in compliance and symptoms by fluticasone. Allergy Asthma Proc. 2003; 24(5):347-51. View

18.

Cochrane M, Bala M, Downs K, Mauskopf J, Ben-Joseph R . Inhaled corticosteroids for asthma therapy: patient compliance, devices, and inhalation technique. Chest. 2000; 117(2):542-50. DOI: 10.1378/chest.117.2.542. View

19.

OByrne P, Pedersen S, Busse W, Tan W, Chen Y, Ohlsson S . Effects of early intervention with inhaled budesonide on lung function in newly diagnosed asthma. Chest. 2006; 129(6):1478-85. DOI: 10.1378/chest.129.6.1478. View

20.

Busse W, Lemanske Jr R . Asthma. N Engl J Med. 2001; 344(5):350-62. DOI: 10.1056/NEJM200102013440507. View