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Inhaler adherence

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https://www.readbyqxmd.com/read/28442901/characteristics-of-copd-patients-initiating-treatment-with-aclidinium-or-tiotropium-in-primary-care-in-catalonia-a-population-based-study
#1
Mònica Monteagudo, Montse Roset, Teresa Rodriguez-Blanco, Laura Muñoz, Marc Miravitlles
OBJECTIVE: To describe and compare demographic and clinical profile of patients newly initiated on aclidinium (ACL) or tiotropium (TIO) and identify factors associated with newly initiated ACL in real-life clinical practice during 2013 in Catalonia. DESIGN: We performed a population-based, retrospective, observational study with data obtained from the Information System for Research Development in Primary Care, a population database that contains information of 5...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28439076/practice-makes-perfect-self-reported-adherence-a-positive-marker-of-inhaler-technique-maintenance
#2
Elizabeth Azzi, Pamela Srour, Carol Armour, Cynthia Rand, Sinthia Bosnic-Anticevich
Poor inhaler technique and non-adherence to treatment are major problems in the management of asthma. Patients can be taught how to achieve good inhaler technique, however maintenance remains problematic, with 50% of patients unable to demonstrate correct technique. The aim of this study was to determine the clinical, patient-related and/or device-related factors that predict inhaler technique maintenance. Data from a quality-controlled longitudinal community care dataset was utilized. 238 patients using preventer medications where included...
April 24, 2017: NPJ Primary Care Respiratory Medicine
https://www.readbyqxmd.com/read/28435870/nanoparticles-that-do-not-adhere-to-mucus-provide-uniform-and-long-lasting-drug-delivery-to-airways-following-inhalation
#3
Craig S Schneider, Qingguo Xu, Nicholas J Boylan, Jane Chisholm, Benjamin C Tang, Benjamin S Schuster, Andreas Henning, Laura M Ensign, Ethan Lee, Pichet Adstamongkonkul, Brian W Simons, Sho-Yu S Wang, Xiaoqun Gong, Tao Yu, Michael P Boyle, Jung Soo Suk, Justin Hanes
Mucoadhesive particles (MAP) have been widely explored for pulmonary drug delivery because of their perceived benefits in improving particle residence in the lungs. However, retention of particles adhesively trapped in airway mucus may be limited by physiologic mucus clearance mechanisms. In contrast, particles that avoid mucoadhesion and have diameters smaller than mucus mesh spacings rapidly penetrate mucus layers [mucus-penetrating particles (MPP)], which we hypothesized would provide prolonged lung retention compared to MAP...
April 2017: Science Advances
https://www.readbyqxmd.com/read/28434269/electronic-adherence-monitoring-device-performance-and-patient-acceptability-a-randomized-control-trial
#4
Amy Hai Yan Chan, Alistair William Stewart, Jeff Harrison, Peter Nigel Black, Edwin Arthur Mitchell, Juliet Michelle Foster
BACKGROUND: To investigate the performance and patient acceptability of an inhaler electronic monitoring device in a real-world childhood asthma population. METHODS: Children 6 to 15 years presenting with asthma to the hospital emergency department and prescribed inhaled corticosteroids were included. Participants were randomized to receive a device with reminder features enabled or disabled for use with their preventer. Device quality control tests were conducted...
April 24, 2017: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/28421352/a-new-role-of-fine-excipient-materials-in-carrier-based-dry-powder-inhalation-mixtures-effect-on-deagglomeration-of-drug-particles-during-mixing-revealed
#5
Ahmed O Shalash, Mustafa M A Elsayed
The potential of fine excipient materials to improve the performance of carrier-based dry powder inhalation mixtures is well acknowledged. The mechanisms underlying this potential are, however, open to question till date. Elaborate understanding of these mechanisms is a requisite for rational rather than empirical development of ternary dry powder inhalation mixtures. While effects of fine excipient materials on drug adhesion to and detachment from surfaces of carrier particle have been extensively investigated, effects on other processes, such as carrier-drug mixing, capsule/blister/device filling, or aerosolization in inhaler devices, have received little attention...
April 18, 2017: AAPS PharmSciTech
https://www.readbyqxmd.com/read/28417456/interventions-to-improve-adherence-to-inhaled-steroids-for-asthma
#6
REVIEW
Rebecca Normansell, Kayleigh M Kew, Elizabeth Stovold
BACKGROUND: Despite its proven efficacy in improving symptoms and reducing exacerbations, many patients with asthma are not fully adherent to their steroid inhaler. Suboptimal adherence leads to poorer clinical outcomes and increased health service utilisation, and has been identified as a contributing factor to a third of asthma deaths in the UK. Reasons for non-adherence vary, and a variety of interventions have been proposed to help people improve treatment adherence. OBJECTIVES: To assess the efficacy and safety of interventions intended to improve adherence to inhaled corticosteroids among people with asthma...
April 18, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28412860/modeling-vascular-inflammation-and-atherogenicity-after-inhalation-of-ambient-levels-of-ozone-exploratory-lessons-from-transcriptomics
#7
Andrea Tham, Dominic Lullo, Sarah Dalton, Siyang Zeng, Ian van Koeverden, Mehrdad Arjomandi
BACKGROUND: Epidemiologic studies have linked inhalation of air pollutants such as ozone to cardiovascular mortality. Human exposure studies have shown that inhalation of ambient levels of ozone causes airway and systemic inflammation and an imbalance in sympathetic/parasympathetic tone. METHODS: To explore molecular mechanisms through which ozone inhalation contributes to cardiovascular mortality, we compared transcriptomics data previously obtained from bronchoalveolar lavage (BAL) cells obtained from healthy subjects after inhalational exposure to ozone (200 ppb for 4 h) to those of various cell samples from 11 published studies of patients with atherosclerotic disease using the Nextbio genomic data platform...
April 16, 2017: Inhalation Toxicology
https://www.readbyqxmd.com/read/28410944/-asthma-control-in-patients-attending-primary-care-in-spain-actis-study
#8
Eduardo Calvo, Juan A Trigueros, Araceli López, Guadalupe Sánchez
OBJECTIVE: To assess prevalence of non controlled (ACT- Asthma Control Test<20) asthma in real world clinical practice in Spain. DESIGN: Observational, cross-sectional study. LOCATION: 58 primary care centers from 13 Autonomous Communities. PARTICIPANTS: Asthma patients attending physicians office to collect repeat prescriptions for continuous treatment (Group A), or due to symptoms worsening (Group B). MAIN MEASUREMENTS: Socio-demographic characteristics (age, gender, education, smoking history), physician's assessment of asthma severity, current treatment for asthma, co-morbidities, healthcare-related resources utilization (primary care or emergency visits, hospitalizations), labour or school absenteeism, ACT score and treatment adherence...
April 12, 2017: Atencion Primaria
https://www.readbyqxmd.com/read/28408806/patient-knowledge-and-pulmonary-medication-adherence-in-adult-patients-with-cystic-fibrosis
#9
Ann Hsu-An Lin, Jennifer G Kendrick, Pearce G Wilcox, Bradley S Quon
BACKGROUND AND OBJECTIVES: Patient knowledge of lung function (ie, forced expiratory volume in 1 s [FEV1]% predicted) and the intended benefits of their prescribed pulmonary medications might play an important role in medication adherence, but this relationship has not been examined previously in patients with cystic fibrosis (CF). METHODS: All patients diagnosed with CF and without prior lung transplantation were invited to complete knowledge and self-reported medication adherence questionnaires during routine outpatient visits to the Adult CF Clinic, St Paul's Hospital, Vancouver, Canada from June 2013 to August 2014...
2017: Patient Preference and Adherence
https://www.readbyqxmd.com/read/28399823/alcohol-use-disorders-among-people-living-with-hiv-aids-in-southern-brazil-prevalence-risk-factors-and-biological-markers-outcomes
#10
Cláudio Moss da Silva, Raúl Andrés Mendoza-Sassi, Luisa Dias da Mota, Maíba Mikhael Nader, Ana Maria Barral de Martinez
BACKGROUND: Alcohol abuse is an important public health problem, frequently unrecognized among people living with HIV/AIDS (PLWHA), and requires investigation and intervention. It is usually associated with lower adherence to highly active antiretroviral therapy (HAART). It can also produce adverse clinical outcomes, such as changes in certain HIV markers, particularly CD4 cell counts and HIV viral loads (VLs). Thus, this study aimed to evaluate the prevalence of alcohol abuse among PLWHA, its associated risk factors and effects on CD4 cell counts and HIV VLs in southern Brazil...
April 11, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28392678/an-empirical-method-to-cluster-objective-nebulizer-adherence-data-among-adults-with-cystic-fibrosis
#11
Zhe H Hoo, Michael J Campbell, Rachael Curley, Martin J Wildman
BACKGROUND: The purpose of using preventative inhaled treatments in cystic fibrosis is to improve health outcomes. Therefore, understanding the relationship between adherence to treatment and health outcome is crucial. Temporal variability, as well as absolute magnitude of adherence affects health outcomes, and there is likely to be a threshold effect in the relationship between adherence and outcomes. We therefore propose a pragmatic algorithm-based clustering method of objective nebulizer adherence data to better understand this relationship, and potentially, to guide clinical decisions...
2017: Patient Preference and Adherence
https://www.readbyqxmd.com/read/28391549/disease-burden-of-mild-asthma-findings-from-a-cross-sectional-real-world-survey
#12
Bo Ding, Mark Small
INTRODUCTION: Most asthma patients have mild disease, although the burden of mild asthma is not well understood nor studied. Some evidence suggests that many patients with mild asthma experience suboptimal symptom control and exacerbations. This study characterizes the burden of illness and treatment patterns among patients with a confirmed diagnosis of mild asthma, defined as GINA Step 1 or Step 2, and residing in China, France, Germany, Italy, Japan, Spain, the United Kingdom, or the United States...
April 8, 2017: Advances in Therapy
https://www.readbyqxmd.com/read/28359651/-therapeutic-adherence-in-asthma-in-france-a-general-review
#13
L Laforest, M Belhassen, G Devouassoux, A Didier, L Letrilliart, É Van Ganse
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...
March 27, 2017: Revue des Maladies Respiratoires
https://www.readbyqxmd.com/read/28356227/production-and-characterization-of-a-pegylated-derivative-of-recombinant-human-deoxyribonuclease-i-for-cystic-fibrosis-therapy
#14
Marie-Julie Guichard, Harshad P Patil, Salome Juliette Koussoroplis, Ruddy Wattiez, Teresinha Leal, Rita Vanbever
Recombinant human deoxyribonuclease I (rhDNase) is the mucolytic agent most widely used for the treatment of respiratory disease in cystic fibrosis. However, rhDNase is rapidly cleared from the lungs which implies a high dosing frequency and limited patient adherence. The aim of this study was to produce a long-acting PEGylated derivative of rhDNase presenting a preserved enzymatic activity. Site-specific PEGylation on the N-terminal (N-ter) leucine residue of rhDNase was achieved by reductive alkylation at acidic pH using linear 20kDa, linear 30kDa or two-arm 40kDa polyethylene glycol (PEG) propionaldehydes...
March 27, 2017: International Journal of Pharmaceutics
https://www.readbyqxmd.com/read/28347975/automated-adherence-reminders-for-high-risk-children-with-asthma-a-research-protocol
#15
Sarah A Adams, Michelle Chan Leach, Chris Feudtner, Victoria A Miller, Chén Collin Kenyon
BACKGROUND: The use of inhaled corticosteroid (ICS) medications has been shown to improve asthma control and reduce asthma-related morbidity and mortality. Two recent randomized trials demonstrated dramatic improvements in ICS adherence by monitoring adherence with electronic sensors and providing automated reminders to participants to take their ICS medications. Given their lower levels of adherence and higher levels of asthma-related emergency department (ED) visits, hospitalizations, and death, urban minority populations could potentially benefit greatly from these types of interventions...
March 27, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28340862/symptom-variability-and-control-in-copd-advantages-of-dual-bronchodilation-therapy
#16
REVIEW
Fabiano Di Marco, Pierachille Santus, Nicola Scichilone, Paolo Solidoro, Marco Contoli, Fulvio Braido, Angelo Guido Corsico
BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a heterogeneous disorder characterized by usually progressive development of airflow obstruction that is not fully reversible. While most patients will experience symptoms throughout the day or in the morning upon awakening, many patients do not experience their symptoms as constant but report variability in symptoms during the course of the day or over time. Symptom variability adversely affects patients' health status and increases the risk of COPD exacerbations...
April 2017: Respiratory Medicine
https://www.readbyqxmd.com/read/28337719/an-early-health-economic-analysis-of-the-potential-cost-effectiveness-of-an-adherence-intervention-to-improve-outcomes-for-patients-with-cystic-fibrosis
#17
Paul Tappenden, Susannah Sadler, Martin Wildman
BACKGROUND: Cystic fibrosis (CF) negatively impacts upon health-related quality of life and survival. Adherence to nebulised treatments is low; improving adherence is hypothesised to reduce rates of exacerbation requiring intravenous antibiotics and lung function decline. OBJECTIVE: A state transition model was developed to assess the cost effectiveness of an intervention aimed at increasing patient adherence to nebulised and inhaled antibiotics compared with current CF care, in advance of the forthcoming CFHealthHub randomised controlled trial (RCT)...
March 23, 2017: PharmacoEconomics
https://www.readbyqxmd.com/read/28284317/the-level-of-diagnostic-assessment-in-severe-asthma-a-nationwide-real-life-study
#18
Anna von Bülow, Vibeke Backer, Uffe Bodtger, Niels Ulrik Søes-Petersen, Karin Dahl Assing, Tina Skjold, Celeste Porsbjerg
INTRODUCTION: Systematic assessment of patients with severe asthma is pivotal to decide which patients are eligible to new biological therapies. However, the level of diagnostic work-up in patients with severe asthma is only poorly investigated. AIMS & OBJECTIVES: To describe the diagnostic work-up in a complete population of patients with severe asthma including: objective confirmation of the asthma diagnosis, and identification of potential treatment barriers, such as poor adherence and poor inhaler technique...
March 2017: Respiratory Medicine
https://www.readbyqxmd.com/read/28276739/the-inca-tm-inhaler-compliance-assessment-tm-a-comparison-with-established-measures-of-adherence
#19
Catherine Moran, Frank Doyle, Imran Sulaiman, Kathleen Bennett, Garrett Greene, Gerard J Molloy, Richard B Reilly, Richard W Costello, Lisa Mellon
OBJECTIVE: To compare the Inhaler Compliance Assessment(TM) (INCA(TM)), a novel audio-recording device objectively measuring timing and proficiency of inhaler use, against established adherence measures, and explore its discriminant and predictive validity. DESIGN: Prospective observational study; 184 chronic obstructive pulmonary disease (COPD) patients used an INCA(TM)-enabled salmeterol/fluticasone inhaler for one-month post-hospital discharge. MAIN OUTCOME MEASURES: INCA(TM) (Attempted, Attempted Interval, Actual) adherence correlated with Doses Used Rate, self-reported adherence and prescription refill for concurrent validity...
February 28, 2017: Psychology & Health
https://www.readbyqxmd.com/read/28275171/variation-in-lung-function-as-a-marker-of-adherence-to-oral-and-inhaled-medication-in-cystic-fibrosis
#20
Helen White, Nicola Shaw, Sarah Denman, Kim Pollard, Sarah Wynne, Daniel Gavin Peckham
The aim of this study was to characterise adherence in an adult population with cystic fibrosis (CF) and to investigate if variation in lung function was a predictor of adherence to treatment.The adherence of patients aged ≥16 years from an adult CF centre was measured by medication possession ratio (MPR) and self-report. Patients were assigned to one of three adherence categories (<50%, 50 to <80%, ≥80%) by their composite score (MPR). Ordinal regression was used to identify predictors of adherence, including coefficient variation measures for forced expiratory volume in 1 s (FEV1), weight and C-reactive protein concentration, measured from 6 months and 12 months before baseline...
March 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
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