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Inhaler adherence

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https://www.readbyqxmd.com/read/28810278/-infections-in-patients-with-home-ventilation
#1
Christian Giesa, Fabian Wolter, Santiago Ewig
In patients with home ventilation, there is a markedly higher probability for lower respiratory infections or pneumonia and severe courses due to comorbidity. Tracheobronchitis and pneumonia are often difficult to distinguish. Tracheobronchitis with pronounced secretion which can't be controlled otherwise can be an indication for antimicrobial therapy.There are no data available in order to establish a recommendation for the initial empiric calculated antimicrobial therapy in patients with home ventilation...
August 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28791752/is-higher-population-level-use-of-ics-laba-combination-associated-with-better-asthma-outcomes-cross-sectional-surveys-of-nationally-representative-populations-in-new-zealand-and-australia
#2
Helen K Reddel, Lutz Beckert, Angela Moran, Tristram Ingham, Rosario D Ampon, Matthew J Peters, Susan M Sawyer
BACKGROUND AND OBJECTIVE: New Zealand (NZ) and Australia (AU) have similarly high asthma prevalence; both have universal public health systems, but different criteria for subsidized medicines. We explored differences in asthma management and asthma-related outcomes between these countries. METHODS: A web-based survey was administered in AU (2012) and NZ (2013) to individuals aged ≥16 years with current asthma, drawn randomly from web-based panels, stratified by national population proportions...
August 9, 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/28783056/diet-quality-throughout-early-life-in-relation-to-allergic-sensitization-and-atopic-diseases-in-childhood
#3
Anh N Nguyen, Niels J Elbert, Suzanne G M A Pasmans, Jessica C Kiefte-de Jong, Nicolette W de Jong, Henriëtte A Moll, Vincent W V Jaddoe, Johan C de Jongste, Oscar H Franco, Liesbeth Duijts, Trudy Voortman
Early-life nutrition is an important modifiable determinant in the development of a child's immune system, and may thereby influence the risk of allergic sensitization and atopic diseases. However, associations between overall dietary patterns and atopic diseases in childhood remain unclear. We examined associations of diet quality in early life with allergic sensitization, self-reported physician-diagnosed inhalant and food allergies, eczema, and asthma among 5225 children participating in a population-based cohort in the Netherlands...
August 5, 2017: Nutrients
https://www.readbyqxmd.com/read/28750556/the-quebec-respiratory-health-education-network-integrating-a-model-of-self-management-education-in-copd-primary-care
#4
Jean Bourbeau, Raquel Farias, Pei Zhi Li, Guylaine Gauthier, Livia Battisti, Valérie Chabot, Marie-France Beauchesne, Denis Villeneuve, Patricia Côté, Louis-Philippe Boulet
The objective of this study is to evaluate whether a chronic obstructive pulmonary disease (COPD) self-management education program with coaching of a case manager improves patient-related outcomes and leads to practice changes in primary care. COPD patients from six family medicine clinics (FMCs) participated in a 1-year educational program offered by trained case managers who focused on treatment adherence, inhaler techniques, smoking cessation, and the use of an action plan for exacerbations. Health-care utilization, health-related quality of life (HRQL), treatment adherence, inhaler technique, and COPD knowledge were assessed at each visit with validated questionnaires...
January 1, 2017: Chronic Respiratory Disease
https://www.readbyqxmd.com/read/28744110/confidence-in-correct-inhaler-technique-and-its-association-with-treatment-adherence-and-health-status-among-us-patients-with-chronic-obstructive-pulmonary-disease
#5
Alpesh N Amin, Vaidyanathan Ganapathy, Adam Roughley, Mark Small
BACKGROUND: Improper use of bronchodilators is associated with poor disease control, nonadherence to long-term therapy, and poor clinical outcomes. Our current understanding of factors associated with correct inhaler use and adherence is limited. We measured physician-and patient-reported confidence in device usage and associations with treatment adherence and COPD-related health status. METHODS: This was an analysis of a US observational, point-in-time survey of physicians and patients...
2017: Patient Preference and Adherence
https://www.readbyqxmd.com/read/28741229/inhaled-antimicrobials-for-ventilator-associated-pneumonia-practical-aspects
#6
Garyphallia Poulakou, Dimitrios K Matthaiou, David P Nicolau, Georgios Siakallis, George Dimopoulos
Positive experience with inhaled antibiotics in pulmonary infections of patients with cystic fibrosis has paved the way for their utilization in mechanically ventilated, critically ill patients with lower respiratory tract infections. A successful antibiotic delivery depends upon the size of the generated particle and the elimination of drug impaction in the large airways and the ventilator circuit. Generated droplet size is mainly affected by the type of the nebulizer employed. Currently, jet, ultrasonic, and vibrating mesh nebulizers are marketed; the latter can deliver optimal antibiotic particle size...
July 24, 2017: Drugs
https://www.readbyqxmd.com/read/28733370/reliable-adherence-to-a-copd-care-bundle-mitigates-system-level-failures-and-reduces-copd-readmissions-a-system-redesign-using-improvement-science
#7
Muhammad Ahsan Zafar, Ralph J Panos, Jonathan Ko, Lisa C Otten, Anthony Gentene, Maria Guido, Katherine Clark, Caroline Lee, Jamie Robertson, Evaline A Alessandrini
BACKGROUND: Readmissions of chronic obstructive pulmonary disease (COPD) have devastating effects on patient quality-of-life, disease progression and healthcare cost. Effective interventions to reduce COPD readmissions are needed. OBJECTIVES: Reduce 30-day all-cause readmissions by (1) creating a COPD care bundle that addresses care delivery failures, (2) using improvement science to achieve 90% bundle adherence. SETTING: An 800-bed academic hospital in Ohio, USA...
July 21, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/28732834/patient-perceived-acceptability-and-behaviour-change-benefits-of-inhaler-reminders-and-adherence-feedback-a-qualitative-study
#8
Juliet M Foster, Helen K Reddel, Tim Usherwood, Susan M Sawyer, Lorraine Smith
INTRODUCTION: Little is known about patients' perceptions of electronic inhaler reminders, which have emerged in recent years as adherence promotion aids. This study explored asthma patients' attitudes toward the acceptability and utility of inhaler reminders. METHODS: Participants from a 6-month cluster randomized controlled trial who received reminders for missed doses via SmartTrack adherence monitors (Adherium Ltd) were interviewed to explore their perceptions; interviews were audio-recorded, transcribed and analysed thematically...
August 2017: Respiratory Medicine
https://www.readbyqxmd.com/read/28732820/the-impact-of-cognitive-impairment-on-self-management-in-chronic-obstructive-pulmonary-disease-a-systematic-review
#9
REVIEW
Chelsea Baird, Janaka Lovell, Marilyn Johnson, Kerrie Shiell, Joseph E Ibrahim
OBJECTIVE: To determine the characteristics of persons with cognitive impairment being able to self-manage in chronic obstructive pulmonary disease (COPD). METHODS: In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidance this systematic review examined all studies in English from 1st January 2000 to 20 February 2016, describing the relationship between cognition and COPD self-management domains in older community dwelling persons with dementia or cognitive impairment...
August 2017: Respiratory Medicine
https://www.readbyqxmd.com/read/28730933/drug-delivery-to-the-lungs-challenges-and-opportunities
#10
Stephen P Newman
Pulmonary drug delivery is relatively complex because the respiratory tract has evolved defense mechanisms to keep inhaled drug particles out of the lungs and to remove or inactivate them once deposited. In addition to these mechanical, chemical and immunological barriers, pulmonary drug delivery is adversely affected by the behavioral barriers of poor adherence and poor inhaler technique. Strategies to mitigate the effects of these barriers include use of inhaler devices and formulations that deliver drug to the lungs efficiently, appropriate inhaler technique and improved education of patients...
July 2017: Therapeutic Delivery
https://www.readbyqxmd.com/read/28720676/inhaler-training-delivered-by-internet-based-home-videoconferencing-improves-technique-and-quality-of-life
#11
Rachel M Thomas, Emily R Locke, Deborah M Woo, Ethan H K Nguyen, Valerie G Press, Troy A Layouni, Emily H Trittschuh, Gayle E Reiber, Vincent S Fan
BACKGROUND: COPD is common, and inhaled medications can reduce the risk of exacerbations. Incorrect inhaler use is also common and may lead to worse symptoms and increased exacerbations. We examined whether inhaler training could be delivered using Internet-based home videoconferencing and its effect on inhaler technique, self-efficacy, quality of life, and adherence. METHODS: In this pre-post pilot study, participants with COPD had 3 monthly Internet-based home videoconference visits with a pharmacist who provided inhaler training using teach-to-goal methodology...
July 18, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28709688/multidisciplinary-consensus-on-the-nonadherence-to-clinical-management-of-inhaled-therapy-in-spanish-asthma-patients
#12
Antolín López-Viña, Jordi Giner, Jesús Molina, Javier Palicio, Javier Plaza, José Antonio Quintano, Santiago Quirce, Cristina Soria, Ana María Uréndez, Vicente Plaza
PURPOSE: Rates of nonadherence to asthma treatment in Spain are between 24% and 76%, which results in poor disease control and increased health care costs. The main objective of this multidisciplinary consensus was to investigate the opinions of health professionals and patients regarding adherence to inhaled therapy in Spain. The results will help to identify the causes of nonadherence and to establish strategies to detect and correct the problem. METHODS: This research was conducted by using a modified Delphi method organized into 2 rounds and involving a panel of 64 physicians, 16 nurses, and 10 community pharmacists...
July 11, 2017: Clinical Therapeutics
https://www.readbyqxmd.com/read/28698321/factors-associated-with-non-persistence-to-oral-and-inhaled-antiviral-therapies-for-seasonal-influenza-a-secondary-analysis-of-a-double-blind-multicentre-randomised-clinical-trial
#13
Remi Flicoteaux, Camelia Protopopescu, Annick Tibi, Thierry Blanchon, Sylvie Van Der Werf, Xavier Duval, Anne Mosnier, Cécile Charlois-Ou, Bruno Lina, Catherine Leport, Sylvie Chevret
OBJECTIVES: We aimed to evaluate and compare non-adherence to oral and inhaled antiviral therapies prescribed of a randomised clinical trial in outpatients with influenza A infection. DESIGN: A parallel, three-arm, double-blinded trial randomly allocated antiviral therapies twice daily for 5 days: (1) oral oseltamivir plus inhaled zanamivir (arm OZ); (2) oseltamivir plus inhaled placebo (arm Opz); or (3) oral placebo plus inhaled zanamivir (arm poZ). Analysis of non-adherence was a secondary objective of the trial...
July 10, 2017: BMJ Open
https://www.readbyqxmd.com/read/28669581/efficacy-tolerability-and-safety-of-non-pharmacological-therapies-for-chronic-pain-an-umbrella-review-on-various-cam-approaches
#14
REVIEW
Bérengère Houzé, Héjar El-Khatib, Caroline Arbour
BACKGROUND: Complementary and alternative medicine (CAM) therapies may be used as a non-pharmacological approach to chronic pain management. While hundreds of trials about individual CAM modality have been conducted, a comprehensive overview of their results is currently lacking for pain clinicians and researchers. AIM: This umbrella review synthesized the quality of meta-analytic evidence supporting the efficacy, tolerability and safety of CAM therapies for the management of chronic pain...
June 29, 2017: Progress in Neuro-psychopharmacology & Biological Psychiatry
https://www.readbyqxmd.com/read/28656664/poor-adherence-to-chronic-obstructive-pulmonary-disease-medications-in-primary-care-role-of-age-disease-burden-and-polypharmacy
#15
Davide L Vetrano, Elisa Bianchini, Graziano Onder, Iacopo Cricelli, Claudio Cricelli, Roberto Bernabei, Germano Bettoncelli, Francesco Lapi
AIM: The aim of the present study was to assess the occurrence and determinants of poor adherence to pharmacological treatment in a cohort of primary care patients with chronic obstructive pulmonary disease (COPD), paying special attention to the role of age, comorbidity and polypharmacy. METHODS: We identified a cohort of COPD patients using the primary care Italian Health Search - IMS Longitudinal Patient Database. We assessed 1-year adherence to COPD maintenance pharmacotherapy (encompassing inhaled corticosteroids, long-acting beta agonists and long-acting anticholinergics)...
June 28, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28643178/economic-evaluation-of-tobramycin-inhalation-powder-for-the-treatment-of-chronic-pulmonary-pseudomonas-aeruginosa-infection-in-patients-with-cystic-fibrosis
#16
Srilekha Panguluri, Praveen Gunda, Laurie Debonnett, Kamal Hamed
BACKGROUND: Chronic lung infection with Pseudomonas aeruginosa occurs in approximately 50% of patients with cystic fibrosis (CF). This infection further compromises lung function, and significantly contributes to the increased healthcare costs. OBJECTIVES: Inhaled tobramycin, used to manage P. aeruginosa infection in CF patients, is available as powder (tobramycin inhalation powder, TIP) and solution (tobramycin inhalation solution, TIS). Evidence suggests increased adherence with the use of TIP over TIS...
August 2017: Clinical Drug Investigation
https://www.readbyqxmd.com/read/28639066/enzymatic-mechanisms-involved-in-evasion-of-fungi-to-the-oxidative-stress-focus-on-scedosporium-apiospermum
#17
C Staerck, P Vandeputte, A Gastebois, A Calenda, S Giraud, N Papon, J P Bouchara, M J J Fleury
The airways of patients with cystic fibrosis (CF) are frequently colonized by various filamentous fungi, mainly Aspergillus fumigatus and Scedosporium species. To establish within the respiratory tract and cause an infection, these opportunistic fungi express pathogenic factors allowing adherence to the host tissues, uptake of extracellular iron, or evasion to the host immune response. During the colonization process, inhaled conidia and the subsequent hyphae are exposed to reactive oxygen species (ROS) and reactive nitrogen species (RNS) released by phagocytic cells, which cause in the fungal cells an oxidative stress and a nitrosative stress, respectively...
June 21, 2017: Mycopathologia
https://www.readbyqxmd.com/read/28626506/impact-of-nonadherence-to-inhaled-corticosteroid-laba-therapy-on-copd-exacerbation-rates-and-healthcare-costs-in-a-commercially-insured-us-population
#18
Jill R Davis, Bingcao Wu, David M Kern, Ozgur Tunceli, Kathleen M Fox, John Horton, Randall F Legg, Frank Trudo
BACKGROUND: Evidence of poor patient adherence to medications for chronic obstructive pulmonary disease (COPD) is well-documented, but its impact on disease exacerbation rates and associated healthcare costs remains unclear. OBJECTIVE: To assess the association between adherence levels to different inhaled corticosteroid/long-acting ß2-adrenergic agonist (LABA) and COPD exacerbation rates and costs in a commercially insured population. METHODS: In this observational cohort study, patients with COPD (aged ≥40 years) who were treatment-naïve to inhaled corticosteroid/LABA and were initiating budesonide plus formoterol or fluticasone plus salmeterol between March 1, 2009, and January 31, 2014, were identified in a national representative claims database and were followed for up to 12 months...
April 2017: American Health & Drug Benefits
https://www.readbyqxmd.com/read/28619778/in-patients-with-severe-uncontrolled-asthma-does-knowledge-of-adherence-and-inhaler-technique-using-electronic-monitoring-improve-clinical-decision-making-a-protocol-for-a-randomised-controlled-trial
#19
Matshediso C Mokoka, Lorna Lombard, Elaine M MacHale, Joanne Walsh, Breda Cushen, Imran Sulaiman, Damien Mc Carthy, Fiona Boland, Frank Doyle, Eoin Hunt, Desmond M Murphy, John Faul, Marcus Butler, Kathy Hetherington, J Mark FitzGerald, Job Fm van Boven, Liam G Heaney, Richard B Reilly, Richard W Costello
INTRODUCTION: Many patients with asthma remain poorly controlled despite the use of inhaled corticosteroids and long-acting beta agonists. Poor control may arise from inadequate adherence, incorrect inhaler technique or because the condition is refractory. Without having an objective assessment of adherence, clinicians may inadvertently add extra medication instead of addressing adherence. This study aims to assess if incorporating objectively recorded adherence from the Inhaler Compliance Assessment (INCA) device and lung function into clinical decision making provides more cost-effective prescribing and improves outcomes...
June 15, 2017: BMJ Open
https://www.readbyqxmd.com/read/28615272/what-do-adolescents-with-asthma-really-think-about-adherence-to-inhalers-insights-from-a-qualitative-analysis-of-a-uk-online-forum
#20
Anna De Simoni, Robert Horne, Louise Fleming, Andrew Bush, Chris Griffiths
OBJECTIVE: To explore the barriers and facilitators to inhaled asthma treatment in adolescents with asthma. DESIGN: Qualitative analysis of posts about inhaler treatment in adolescents from an online forum for people with asthma. Analysis informed by the Perceptions and Practicalities Approach. PARTICIPANTS: Fifty-four forum participants (39 adolescents ≥16 years, 5 parents of adolescents, 10 adults with asthma) identified using search terms 'teenager inhaler' and 'adolescent inhaler'...
June 13, 2017: BMJ Open
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