AIMS: To identify specific patterns of corticosteroid use and examine their relationship with asthma outcomes. METHODS: An adherence questionnaire was developed and applied in a population-based observational survey; this compared unscheduled care visits and asthma quality of life for adherent and non-adherent patient groups within 176 patients from a semi-rural UK practice. RESULTS: Three main patterns of medication use were identified: Regular; Regular-but-less (Low-Dosing); and Symptom-Directed variation. For mild-to-moderate asthma (BTS treatment step 2), non-adherence produced acceptable outcomes, not significantly different from outcomes for adherent patients. For more severe asthma, regular adherence was more effective, resulting in significantly less unscheduled visits. CONCLUSIONS: The results suggest that flexible 'symptom-directed' medication use and patient-initiated dose reduction may be viable alternatives to regular medication for a number of lower severity patients. For milder asthma, clinicians should perhaps focus their efforts on patients with poor asthma outcomes, rather than poor adherence.
AIMS: To identify specific patterns of corticosteroid use and examine their relationship with asthma outcomes. METHODS: An adherence questionnaire was developed and applied in a population-based observational survey; this compared unscheduled care visits and asthma quality of life for adherent and non-adherent patient groups within 176 patients from a semi-rural UK practice. RESULTS: Three main patterns of medication use were identified: Regular; Regular-but-less (Low-Dosing); and Symptom-Directed variation. For mild-to-moderate asthma (BTS treatment step 2), non-adherence produced acceptable outcomes, not significantly different from outcomes for adherent patients. For more severe asthma, regular adherence was more effective, resulting in significantly less unscheduled visits. CONCLUSIONS: The results suggest that flexible 'symptom-directed' medication use and patient-initiated dose reduction may be viable alternatives to regular medication for a number of lower severity patients. For milder asthma, clinicians should perhaps focus their efforts on patients with poor asthma outcomes, rather than poor adherence.
Authors: Montserrat M Graves; Christina D Adams; Jade A Bender; Stacey Simon; And Jay M Portnoy Journal: Curr Allergy Asthma Rep Date: 2007-11 Impact factor: 4.806
Authors: Michael E Hyland; Ben Whalley; David M G Halpin; Colin J Greaves; Clare Seamark; Sue Blake; Margaret Pinnuck; David Ward; Adam Hawkins; Dave Seamark Journal: Prim Care Respir J Date: 2012-12