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Inhaler adherence

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https://www.readbyqxmd.com/read/29470253/management-of-nontuberculous-mycobacterial-pulmonary-disease
#1
Mark H Adelman, Doreen J Addrizzo-Harris
PURPOSE OF REVIEW: To highlight recent original research and specialty society guidelines regarding the diagnosis and treatment of nontuberculous mycobacterial (NTM) pulmonary disease. RECENT FINDINGS: The prevalence of NTM pulmonary disease has risen in recent years. The prevalence of individual NTM species varies geographically, although Mycobacterium avium complex (MAC) and Mycobacterium abscessus complex (MABC) remain among the most commonly encountered in many regions...
February 20, 2018: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/29469993/asthma-among-adult-patients-presenting-with-dyspnea-to-the-emergency-department-an-observational-study
#2
Win Sen Kuan, Simon Craig, Anne-Maree Kelly, Gerben Keijzers, Sharon Klim, Colin A Graham, Peter Jones, Anna Holdgate, Charles Lawoko, Said Laribi
INTRODUCTION: Shortness of breath is a common presenting symptom to the emergency department (ED) that can arise from a myriad of possible diagnoses. Asthma is one of the major causes. OBJECTIVE: To describe the demographic features, clinical characteristics, management and outcomes of adults with an emergency department (ED) diagnosis of asthma who presented to an ED in the Asia Pacific region with a principal symptom of dyspnea. METHODS: Planned sub-study of patients with an ED diagnosis of asthma identified in the Asia, Australia and New Zealand Dyspnoea in Emergency Departments (AANZDEM) study...
February 22, 2018: Clinical Respiratory Journal
https://www.readbyqxmd.com/read/29466963/pediatric-severe-asthma-a-case-series-report-and-perspectives-on-anti-ige-treatment
#3
Virginia Mirra, Silvia Montella, Francesca Santamaria
BACKGROUND: The primary goal of asthma management is to achieve disease control for reducing the risk of future exacerbations and progressive loss of lung function. Asthma not responding to treatment may result in significant morbidity. In many children with uncontrolled symptoms, the diagnosis of asthma may be wrong or adherence to treatment may be poor. It is then crucial to distinguish these cases from the truly "severe therapy-resistant" asthmatics by a proper filtering process...
February 21, 2018: BMC Pediatrics
https://www.readbyqxmd.com/read/29461875/assessing-adherence-to-inhaled-medication-in-asthma-impact-of-once-daily-versus-twice-daily-dosing-frequency-the-ataud-study
#4
Luis Pérez de Llano, Abel Pallares Sanmartin, Francisco Javier González-Barcala, Mar Mosteiro-Añón, Dolores Corbacho Abelaira, Raquel Dacal Quintas, María Merino Ventosa
INTRODUCTION: This study was aimed at evaluating whether once-daily regimens (od-r) show benefits in adherence when compared to twice-daily (td-r). METHODS: Prospective, multicenter, 6-month follow-up study with two visits. The main objective was to compare adherence assessed by the electronic prescription refill rate (EPRR) and by the 10-item Test of Adherence to Inhalers (TAI) in patients with od-r and td-r. Suboptimal adherence was defined as TAI < 50 or EPRR ≤ 80%...
February 20, 2018: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/29461017/medication-adherence-in-pediatric-asthma-a-systematic-review-of-the-literature
#5
REVIEW
Wendy N Gray, Mallory Netz, Andrew McConville, David Fedele, Scott T Wagoner, Megan R Schaefer
OBJECTIVE: To provide a systematic review of correlates of adherence to inhaled corticosteroids (ICS) in pediatric asthma across the individual, family, community, and healthcare system domains. METHODS: Articles assessing medication adherence in pediatric asthma published from 1997 to 2016 were identified using PsychINFO, Medline, and CINAHL. Search terms included asthma, compliance, self-management, adherence, child, and youth. Search results were limited to articles: 1) published in the US; 2) using a pediatric population (0-25 years old); and 3) presenting original data related to ICS adherence...
February 20, 2018: Pediatric Pulmonology
https://www.readbyqxmd.com/read/29439942/using-robots-at-home-to-support-patients-with-chronic-obstructive-pulmonary-disease-pilot-randomized-controlled-trial
#6
Elizabeth Broadbent, Jeff Garrett, Nicola Jepsen, Vickie Li Ogilvie, Ho Seok Ahn, Hayley Robinson, Kathryn Peri, Ngaire Kerse, Paul Rouse, Avinesh Pillai, Bruce MacDonald
BACKGROUND: Socially assistive robots are being developed for patients to help manage chronic health conditions such as chronic obstructive pulmonary disease (COPD). Adherence to medication and availability of rehabilitation are suboptimal in this patient group, which increases the risk of hospitalization. OBJECTIVE: This pilot study aimed to investigate the effectiveness of a robot delivering telehealth care to increase adherence to medication and home rehabilitation, improve quality of life, and reduce hospital readmission compared with a standard care control group...
February 13, 2018: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/29437489/controller-adherence-following-hospital-discharge-in-high-risk-children-a-pilot-randomized-trial-of-text-message-reminders
#7
Chén C Kenyon, Siobhan M Gruschow, William O Quarshie, Heather Griffis, Michelle C Leach, Joseph J Zorc, Tyra C Bryant-Stephens, Victoria A Miller, Chris Feudtner
OBJECTIVE: To assess the feasibility of a mobile health, inhaled corticosteroid (ICS) adherence reminder intervention and to characterize adherence trajectories immediately following severe asthma exacerbation in high-risk urban children with persistent asthma. METHODS: Children aged 2-13 with persistent asthma were enrolled in this pilot randomized controlled trial during an asthma emergency department (ED) visit or hospitalization. Intervention arm participants received daily text message reminders for 30 days, and both arms received electronic sensors to measure ICS use...
February 13, 2018: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/29431734/disruption-of-staphylococcal-aggregation-protects-against-lethal-lung-injury
#8
Jaime L Hook, Mohammad N Islam, Dane Parker, Alice S Prince, Sunita Bhattacharya, Jahar Bhattacharya
Infection by Staphylococcus aureus strain USA300 causes tissue injury, multiorgan failure, and high mortality. However, the mechanisms by which the bacteria adhere to, then stabilize on, mucosal surfaces before causing injury remain unclear. We addressed these issues through the first real-time determinations of USA300-alveolar interactions in live lungs. We found that within minutes, inhaled USA300 established stable, self-associated microaggregates in niches at curved, but not at flat, regions of the alveolar wall...
February 12, 2018: Journal of Clinical Investigation
https://www.readbyqxmd.com/read/29427989/diagnosis-and-management-of-severe-asthma
#9
Kian Fan Chung
Severe therapy-resistant asthma has been defined as "asthma which requires treatment with high dose inhaled corticosteroids (ICSs) plus a second controller (and/or systemic corticosteroids) to prevent it from becoming 'uncontrolled' or which remains 'uncontrolled' despite this therapy". Patients who usually present with 'difficult-to-treat asthma' should first be assessed to determine whether he/she has asthma with the exclusion of other diagnoses and if so, whether the asthma can be classified as severe therapy-resistant...
February 2018: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29427988/emerging-concepts-in-evidence-based-asthma-management
#10
Helen K Reddel
Asthma management is in an intriguing phase, with acceptance of asthma as a heterogeneous condition with different phenotypes and underlying mechanisms and the potential for personalized asthma care, in parallel with increasing evidence about the population-level impact of basic strategies to increase access to medicines and improve inhaler technique and adherence. These changes have been facilitated by a more comprehensive view of evidence, including both randomized controlled trials with high internal validity and pragmatic and observational studies with high generalizability to patients in clinical practice...
February 2018: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29423368/multifaceted-interventions-to-reduce-acute-exacerbations-in-elderly-asthmatics
#11
So-Hee Lee, Woo-Jung Song, Heung-Woo Park, Min-Gyu Kang, Sae-Hoon Kim, Hye-Kyung Park, Sang-Heon Kim, Yong-Eun Kwon, Tae-Bum Kim, Byung-Jae Lee, Young-Koo Jee, Byung-Whui Choi, Sang-Heon Cho, Sun-Sin Kim
Background: Although many risk factors are known to be associated with poor asthma outcomes in the elderly, the literature on the effect of risk factor control on asthma outcomes in the elderly is very sparse. Objective: To evaluate the role of multifaceted interventions in reducing acute exacerbations in elderly asthmatics. Methods: A total of 100 subjects were randomly selected from our prospective cohort of elderly asthmatics aged 65 years or older and were provided multifaceted intervention for 1 year...
January 2018: Asia Pacific Allergy
https://www.readbyqxmd.com/read/29420091/concordance-among-children-caregivers-and-clinicians-on-barriers-to-controller-medication-use
#12
Carolyn M Arnold, Paul J Bixenstine, Tina L Cheng, Megan M Tschudy
OBJECTIVE: While much research has addressed asthma medication adherence, few have combined quantitative and qualitative data, and none has addressed the triad of child, caregiver, and clinician simultaneously. This study assessed, with mixed methods, barriers to medication adherence within this triad. METHODS: We conducted interviews with publicly-insured children with asthma, their caregivers, and their primary-care clinicians. Children (7-17 years) had been prescribed daily inhaled corticosteroids and visited the ED for asthma (past year)...
February 8, 2018: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/29417739/seventeen-year-nationwide-trends-in-use-of-long-acting-bronchodilators-and-inhaled-corticosteroids-among-adults-a-danish-drug-utilization-study
#13
Mette Reilev, Anton Pottegård, Jesper Rømhild Davidsen, Lotte Rasmussen, Jens Søndergaard, Christian B Laursen, Daniel Pilsgaard Henriksen
Long-acting bronchodilators and inhaled corticosteroids (ICS) are the cornerstones in treatment of chronic obstructive and inflammatory pulmonary diseases. However, non-adherence to guidelines is widespread. Detailed information on real-life treatment patterns is needed to promote rational use. We aimed to investigate nationwide time trends in individual-level treatment patterns of long-acting bronchodilators and ICS. Using nationwide Danish health registries, we identified all Danish adults with a prescription for long-acting bronchodilators and/or ICS from 2000-2016...
February 8, 2018: Basic & Clinical Pharmacology & Toxicology
https://www.readbyqxmd.com/read/29413503/co-suspension-delivery-technology-in-pressurized-metered-dose-inhalers-for-multi-drug-dosing-in-the-treatment-of-respiratory-diseases
#14
REVIEW
Gary T Ferguson, Anthony J Hickey, Sarvajna Dwivedi
Technologies for long-term delivery of aerosol medications in asthma and chronic obstructive pulmonary disease have improved over the past 2 decades with advancements in our understanding of the physical chemistry of aerosol formulations, device engineering, aerosol physics, and pulmonary biology. However, substantial challenges remain when a patient is required to use multiple inhaler types, multiple medications, and/or combinations of medications. Combining multiple drugs into a single inhaler while retaining appropriate dosing of the individual agents in the combination may enhance patient adherence to therapy and reduce device errors that occur when patients are using multiple inhalers...
January 2018: Respiratory Medicine
https://www.readbyqxmd.com/read/29408439/clinician-agreement-self-efficacy-and-adherence-with-the-guidelines-for-the-diagnosis-and-management-of-asthma
#15
Michelle M Cloutier, Paivi M Salo, Lara J Akinbami, Richard D Cohn, Jesse C Wilkerson, Gregory B Diette, Sonja Williams, Kurtis S Elward, Jacek M Mazurek, Jovonni R Spinner, Tracey A Mitchell, Darryl C Zeldin
BACKGROUND: The 2007 Guidelines for the Diagnosis and Management of Asthma provide evidence-based recommendations to improve asthma care. Limited national-level data are available about clinician agreement and adherence to these guidelines. OBJECTIVE: To assess clinician-reported adherence with specific guideline recommendations, as well as agreement with and self-efficacy to implement guidelines METHODS: We analyzed 2012 National Asthma Survey of Physicians data for 1412 primary care clinicians and 233 asthma specialists about four cornerstone guideline domains: asthma control, patient education, environmental control, and pharmacologic treatment...
February 2, 2018: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/29402662/pharmacist-managed-short-acting-beta-agonist-refill-service-in-a-general-pediatric-clinic
#16
Brooke L Gildon, Barnabas John, Michelle Condren, Shellie Keast, Roxanne Maglunog, Jeremy L Johnson, Christopher Robertson
OBJECTIVES: To use a pharmacist-managed short-acting beta agonist (SABA) service (1) to determine the patient's rationale for SABA refill requests, (2) to assess adherence to current controller therapy and current level of disease control, and (3) to characterize the pharmacist's recommendations made in response to a patient's SABA refill request. SETTING: An academic-based general pediatric clinic. PRACTICE DESCRIPTION: SABA overuse is a marker of increased morbidity and mortality in children with asthma...
February 3, 2018: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/29400090/symbicort%C3%A2-maintenance-and-reliever-therapy-smart-and-the-evolution-of-asthma-management-within-the-gina-guidelines
#17
Jiangtao Lin, Xin Zhou, Changzheng Wang, Chuntao Liu, Shaoxi Cai, Mao Huang
The Global Initiative for Asthma (GINA) annual report summarizes the latest evidence for asthma management. GINA recommends stepwise pharmacological treatment, advocating inhaled corticosteroids (ICS) plus rapid, long-acting β2-agonists (LABA) delivered in a single inhaler for maintenance and relief at Steps 3 (moderate persistent asthma requiring 1-2 controllers plus as-needed reliever), 4 (severe persistent asthma requiring ≥2 controllers plus as-needed reliever), and 5 (higher level care and/or add-on treatment)...
February 5, 2018: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/29382592/the-obese-asthma-phenotype-in-children-an-exacerbating-situation
#18
Cristina Longo, Gillian Bartlett, Tibor Schuster, Francine M Ducharme, Brenda MacGibbon, Tracie A Barnett
BACKGROUND: Current evidence regarding the relationship between childhood obesity, decreased response to inhaled corticosteroids (ICS), and poor asthma control is conflicting. OBJECTIVES: We assessed if obesity: i) is associated with time-to-first exacerbation among children with asthma initiating Step-3 maintenance therapies; ii) modifies the effectiveness of Step-3 therapies. METHODS: A retrospective cohort study was conducted from clinical data linked to health and drug administrative databases...
January 27, 2018: Journal of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/29371569/cryptococcus-epithelial-interactions
#19
REVIEW
Leanne M Taylor-Smith
The fungal pathogen, Cryptococcus neoformans, causes devastating levels of morbidity and mortality. Infections with this fungus tend to be predominantly in immunocompromised individuals, such as those with HIV. Infections initiate with inhalation of cryptococcal cells and entry of the pathogen into the lungs. The bronchial epithelial cells of the upper airway and the alveolar epithelial cells of the lower airway are likely to be the first host cells that Cryptococcus engage with. Thus the interaction of cryptococci and the respiratory epithelia will be the focus of this review...
October 2, 2017: Journal of Fungi (Basel, Switzerland)
https://www.readbyqxmd.com/read/29369804/knowledge-of-inhaled-therapy-and-responsibility-for-asthma-management-among-young-teens-with-uncontrolled-persistent-asthma
#20
Sean M Frey, Marybeth R Jones, Nicolas Goldstein, Kristin Riekert, Maria Fagnano, Jill S Halterman
OBJECTIVES: To compare the abilities of teens with uncontrolled persistent asthma and their caregivers to identify inhaled medications and state correct indications for use; examine medication responsibility within dyads; and determine whether responsibility is associated with knowledge about inhaled therapies. DESIGN/METHODS: In the baseline survey for the School-Based Asthma Care for Teens (SB-ACT) trial, we separately asked caregivers and teens to: 1) identify the teen's inhaled asthma therapies by name and from a picture chart (complete matches considered "concordant"); 2) describe indications of use for each medication; 3) describe the allocation of responsibility for medication use within dyads...
January 21, 2018: Academic Pediatrics
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