INTRODUCTION: Inhaled medications, critical for asthma treatment, are self-administered through metered dose inhalers (MDI). Asthma self-management hinges on adherence to these medications and to proper MDI technique. OBJECTIVE: To assess predictors of proper MDI technique, and MDI technique as a tool to identify patients with low adherence to inhaled medications. METHODS: Prospective cohort of asthmatics from clinics in New York, NY and New Brunswick, NJ. MDI technique was assessed using a standardized checklist. Adherence to inhaled asthma controller medication was evaluated with the Medication Adherence Report Scale. Predictors of MDI technique were evaluated using regression analyses. The distribution of number of MDI technique steps missed was compared in adherent vs. non-adherent asthmatics. RESULTS: Overall, 326 patients were included (55% Hispanic, 27% Black). In adjusted analyses, age < 55 years was significantly associated with MDI technique (P = 0.03). Overall, 12%, 34%, 40% of asthmatics missed 5-6, 3-4, or 1-2 MDI steps; 16% received a perfect MDI technique score. Adherence rates were 20%, 39%, 48%, and 62% among those who missed 5-6, 3-4, 1-2, or none of the steps in the MDI technique checklist (P < 0.001). CONCLUSION: Poor MDI technique is common among inner-city patients with asthma and is associated with poor adherence to controller medications. Older patients with asthma are at higher risk of improper MDI technique. Assessment of MDI technique may be a simple clinical aid to identify patients with low adherence to controller medications.
INTRODUCTION: Inhaled medications, critical for asthma treatment, are self-administered through metered dose inhalers (MDI). Asthma self-management hinges on adherence to these medications and to proper MDI technique. OBJECTIVE: To assess predictors of proper MDI technique, and MDI technique as a tool to identify patients with low adherence to inhaled medications. METHODS: Prospective cohort of asthmatics from clinics in New York, NY and New Brunswick, NJ. MDI technique was assessed using a standardized checklist. Adherence to inhaled asthma controller medication was evaluated with the Medication Adherence Report Scale. Predictors of MDI technique were evaluated using regression analyses. The distribution of number of MDI technique steps missed was compared in adherent vs. non-adherent asthmatics. RESULTS: Overall, 326 patients were included (55% Hispanic, 27% Black). In adjusted analyses, age < 55 years was significantly associated with MDI technique (P = 0.03). Overall, 12%, 34%, 40% of asthmatics missed 5-6, 3-4, or 1-2 MDI steps; 16% received a perfect MDI technique score. Adherence rates were 20%, 39%, 48%, and 62% among those who missed 5-6, 3-4, 1-2, or none of the steps in the MDI technique checklist (P < 0.001). CONCLUSION: Poor MDI technique is common among inner-city patients with asthma and is associated with poor adherence to controller medications. Older patients with asthma are at higher risk of improper MDI technique. Assessment of MDI technique may be a simple clinical aid to identify patients with low adherence to controller medications.
Authors: Jaco Voorham; Bernard Vrijens; Job Fm van Boven; Dermot Ryan; Marc Miravitlles; Lisa M Law; David B Price Journal: Pragmat Obs Res Date: 2017-04-18
Authors: Ai Theng Cheong; Ping Yein Lee; Sazlina Shariff-Ghazali; Hani Salim; Norita Hussein; Rizawati Ramli; Hilary Pinnock; Su May Liew; Nik Sherina Hanafi; Ahmad Ihsan Abu Bakar; Azainorsuzila Mohd Ahad; Yong Kek Pang; Karuthan Chinna; Ee Ming Khoo Journal: NPJ Prim Care Respir Med Date: 2021-11-29 Impact factor: 2.871
Authors: Seong Dae Woo; Young Min Ye; Youngsoo Lee; So Hee Lee; Yoo Seob Shin; Joo Hun Park; Hyunna Choi; Hyun Young Lee; Hyun Jung Shin; Hae Sim Park Journal: Allergy Asthma Immunol Res Date: 2020-05 Impact factor: 5.764