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Inhaler adherence

D Costa Santos, F Barros, M Frazão, M Maia
Face burns expose patients to a higher respiratory risk, and early prophylactic intubation before they enter the burn unit might be life-saving. However, unnecessary intubation may compromise their clinical evolution. Hence, the decision to perform pre-burn centre endotracheal intubation remains a clinical challenge. A retrospective study was developed to characterize the experience of the tertiary burn unit of the Hospital da Prelada with face burn patients arriving endotracheally-intubated between January 2009 and September 2013...
December 31, 2015: Annals of Burns and Fire Disasters
Vicente Plaza, Antolín López-Viña, Borja G Cosio
No abstract text is available yet for this article.
October 15, 2016: Archivos de Bronconeumología
Kathryn V Blake
PURPOSE OF REVIEW: Poor adherence to asthma controller medications, particularly inhaled corticosteroids, has been well known for decades and is a major cause of uncontrolled asthma and increased healthcare utilization. This review presents recent evidence on factors leading to nonadherence in specific age groups, parents of young children, adolescents and young adults, adults, and the elderly. Novel management strategies including electronic sensors with associated smart phone applications for adherence improvement are discussed...
October 15, 2016: Current Opinion in Pulmonary Medicine
Mark A Otto, Nicholas J Martin, Jennifer S Rous, Michael E Stevens
Dichlorvos is a chemical compound which has been used for decades as a pesticide. Potential inhalational exposure to dichlorvos vapor associated with using commercially-based, dichlorvos-impregnated resin strips in a simulated military guard post was evaluated. A varying number of these pesticide strips, ranging from the manufacturer's guidelines ((3)-16 g strips) up to a full package of strips ((12)-16 g strips), were placed in a small, enclosed space (2.31 m × 2.26 m × 2.44 m, 12.7 m(3)), which was similar in size to a typical military guard post...
October 18, 2016: Journal of Occupational and Environmental Hygiene
Gennaro D'Amato, Carolina Vitale, Antonio Molino, Anna Stanziola, Alessandro Sanduzzi, Alessandro Vatrella, Mauro Mormile, Maurizia Lanza, Giovanna Calabrese, Leonardo Antonicelli, Maria D'Amato
Despite major advances in the treatment of asthma and the development of several asthma guidelines, people still die of asthma currently. According to WHO estimates, approximately 250,000 people die prematurely each year from asthma. Trends of asthma mortality rates vary very widely across countries, age and ethnic groups. Several risk factors have been associated with asthma mortality, including a history of near-fatal asthma requiring intubation and mechanical ventilation, hospitalization or emergency care visit for asthma in the past year, currently using or having recently stopped using oral corticosteroids (a marker of event severity), not currently using inhaled corticosteroids, a history of psychiatric disease or psychosocial problems, poor adherence with asthma medications and/or poor adherence with (or lack of) a written asthma action plan, food allergy in a patient with asthma...
2016: Multidisciplinary Respiratory Medicine
Caroline Anne Mitchell, Alice Pitt, Joe Hulin, Rod Lawson, Fleur Ashby, Ivan Appelqvist, Brigitte Delaney
OBJECTIVES: Increased rates of illicit drug inhalation are thought to expose opiate misusers (OMUs) to an enhanced risk of respiratory health problems. This pilot study aimed to determine the feasibility of undertaking respiratory screening of OMUs in a community clinic. SETTING: Single-centre UK community substance misuse clinic. PARTICIPANTS: All clinic attendees receiving treatment for opiate misuse were eligible to participate. 36 participants (mean age=37) were recruited over a 5-week period...
October 14, 2016: BMJ Open
Kate E George, Dorothy M Ryan, Brian Keevil, Robert Niven, Stephen J Fowler
There is currently no direct measure of measuring adherence to inhaled corticosteroids in asthma. In this study we were able to detect fluticasone propionate and budesonide in the serum of treatment-adherent patients with severe asthma.
October 11, 2016: Journal of Allergy and Clinical Immunology
Erin Davis, Carlo Marra, John-Michael Gamble, Jamie Farrell, Joe Lockyer, J Mark FitzGerald, Waseem Abu-Ashour, Charlie Gillis, John Hawboldt
BACKGROUND: Patients with chronic obstructive pulmonary disease (COPD) are often nonadherent with medications and have poor inhaler technique. Community pharmacists can help to improve health-related quality of life and overall outcomes in patients with COPD. We aim to measure the effectiveness of a systematic, pharmacist-driven intervention on patients with diagnosed COPD. METHODS/DESIGN: This pragmatic, parallel-group, cluster randomized controlled trial is designed to determine the effectiveness of a multifactorial, pharmacist-led intervention on medication adherence, inhaler technique, health-related quality of life, health care resource utilization including COPD exacerbations, and use of medications...
October 13, 2016: Trials
Amy H Y Chan, Alistair W Stewart, Juliet M Foster, Edwin A Mitchell, Carlos A Camargo, Jeff Harrison
Adherence to preventive asthma treatment is poor, particularly in children, yet the factors associated with adherence in this age group are not well understood. Adherence was monitored electronically over 6 months in school-aged children who attended a regional emergency department in New Zealand for an asthma exacerbation and were prescribed twice-daily inhaled corticosteroids. Participants completed questionnaires including assessment of family demographics, asthma responsibility and learning style. Multivariable analysis of factors associated with adherence was conducted...
January 2016: ERJ Open Research
Ronald Dahl, Alan Kaplan
BACKGROUND: In many countries worldwide, the long-acting anticholinergic drug tiotropium is available as a dry powder formulation delivered by means of the HandiHaler® inhalation device and as an aqueous solution delivered via the Respimat® Soft Mist™ Inhaler. Tiotropium HandiHaler® is a single-dose, dry powder, breath-actuated inhaler that provides delivered doses and lung deposition of tiotropium that are, over a wide range, not influenced by the severity of chronic obstructive pulmonary disease (COPD)...
October 11, 2016: BMC Pulmonary Medicine
Ryo Atsuta, Yasuo To, Susumu Sakamoto, Isao Mukai, Akihiro Kobayashi, Arisa Kinoshita, Kazuhisa Takahashi
BACKGROUND: Maintaining high treatment adherence levels is critical for effective management of chronic diseases. The Adherence Starts with Knowledge 20 (ASK-20) questionnaire is the only linguistically validated patient-reported treatment adherence tool available in Japan. We conducted additional analyses on ASK-20 data from Japanese adults with asthma. METHODS: This was a prospective, non-interventional, single-visit, multi-centre study in Japanese adults (n = 300) with asthma receiving long-term treatment with inhaled corticosteroids (ICS) or ICS/long-acting beta-agonists...
October 3, 2016: Allergology International: Official Journal of the Japanese Society of Allergology
Lucie Blais, Fatima-Zohra Kettani, Amélie Forget, Marie-France Beauchesne, Catherine Lemière, Francine M Ducharme
PURPOSE: There are very few studies on primary adherence (i.e., first filling of a prescription) to inhaled corticosteroids (ICS) in asthma patients; two have involved children. Moreover, adherence can be overestimated when considering only secondary adherence (i.e., following the medication recommendations for a defined period) and ignoring primary adherence. We aimed thus to evaluate the real-world primary and secondary adherence to ICS and to develop an integrated primary and secondary adherence (IPSA) measure...
October 1, 2016: European Journal of Clinical Pharmacology
Sandra Søgaard Tøttenborg, Peter Lange, Søren Paaske Johnsen, Henrik Nielsen, Truls Sylvan Ingebrigtsen, Reimar Wernich Thomsen
BACKGROUND: Low socioeconomic status has been associated with adverse outcomes in chronic obstructive pulmonary disease (COPD), but population-based data are sparse. We examined the impact of education, employment, income, ethnicity, and cohabitation on the risk of suboptimal adherence to inhaled medication, exacerbations, acute admissions, and mortality among COPD patients. METHODS: Using nationwide healthcare registry data we identified 13,369 incident hospital clinic outpatients with COPD during 2008-2012...
October 2016: Respiratory Medicine
Thaigarajan Parumasivam, Sharon S Y Leung, Patricia Tang, Citterio Mauro, Warwick Britton, Hak-Kim Chan
The routine of loading multiple capsules for delivery of high-dose antibiotics is time consuming, which may reduce patient adherence to inhaled treatment. To overcome this limitation, an investigation was carried out using four modified versions of the Aerolizer® that accommodate a size 0 capsule for delivery of high payload formulations. In some prototypes, four piercing pins of 0.6 mm each were replaced with a single centrally located 1.2-mm pin and one-third reduced air inlet of the original design. The performance of these inhalers was evaluated using spray-dried antibiotic powders with distinct morphologies: spherical particles with a highly corrugated surface (colistin and tobramycin) and needle-like particles (rifapentine)...
September 27, 2016: AAPS Journal
Dan Xu, Yingshuo Wang, Zhimin Chen, Shuxian Li, Yungai Cheng, Li Zhang, Lingzhi Zhao
BACKGROUND: Asthma is a global problem. Prevalence varies among different countries and cities. We aimed to obtain the prevalence, describe the characteristics, and discover factors that may relate to asthma in Hangzhou. METHODS: This cross-sectional study was conducted in Hangzhou. The subjects were children aged 14 years and younger. A control group of non-asthma children that matched in age and sex with each asthmatic patient was also randomly selected and interviewed...
September 27, 2016: Respiratory Research
Jonathan M Feldman, Lynne Matte, Alejandro Interian, Paul M Lehrer, Shou-En Lu, Bari Scheckner, Dara M Steinberg, Tanya Oken, Anu Kotay, Sumita Sinha, Chang Shim
Confusion between panic and asthma symptoms can result in serious self-management errors. A cognitive behavior psychophysiological therapy (CBPT) intervention was culturally adapted for Latinos consisting of CBT for panic disorder (PD), asthma education, differentiation between panic and asthma symptoms, and heart rate variability biofeedback. An RCT compared CBPT to music and relaxation therapy (MRT), which included listening to relaxing music and paced breathing at resting respiration rates. Fifty-three Latino (primarily Puerto Rican) adults with asthma and PD were randomly assigned to CBPT or MRT for 8 weekly sessions...
September 17, 2016: Behaviour Research and Therapy
Josep Darbà, Gabriela Ramírez, Juan L García-Rivero, Sagrario Mayoralas-Alises, José Francisco Pascual, Albert Roger, Diego Vargas, Adi Bijedic
OBJECTIVE: To assess the economic impact of the introduction of DuoResp(®) Spiromax(®) by focusing on a potential improvement in the inhalation technique to strengthen medication adherence for the treatment of moderate to severe asthmatics in Spain and five Spanish regions including Andalusia, Catalonia, Galicia, Madrid, and Valencia. METHODS: A 4-year budget impact model was developed for the period 2015-2018 from the Spanish Healthcare System perspective. Budesonide-formoterol fixed-dose combination delivered by Turbuhaler(®) was considered to be the most appropriate comparator for assessing the budget impact with the introduction of DuoResp(®) Spiromax(®)...
2016: ClinicoEconomics and Outcomes Research: CEOR
Almudena Ortega Gomez, Melanie Salvermoser, Jan Rossaint, Robert Pick, Janine Brauner, Patricia Lemnitzer, Jessica Tilgner, Renske de Jong, Remco T A Megens, Janina Jamasbi, Yvonne Döring, Christine T Pham, Christoph Scheiermann, Wolfgang Siess, Maik Drechsler, Christian Weber, Jochen Grommes, Alexander Zarbock, Barbara Walzog, Oliver Soehnlein
BACKGROUND: -Therapeutic targeting of arterial leukocyte recruitment in the context of atherosclerosis has been disappointing in clinical studies. Reasons for such failures include the lack of knowledge of arterial-specific recruitment patterns. Here we establish the importance of the Cathepsin G (CatG) in the context of arterial myeloid cell recruitment. METHODS: -Intravital microscopy of the carotid artery, the jugular vein and cremasteric arterioles and venules in Apoe(-/-) and CatG-deficient mice Apoe(-/-)Ctsg(-/-)) mice was employed to study site-specific myeloid cell behavior after high fat diet (HFD) feeding or TNF stimulation...
September 22, 2016: Circulation
Sam Howard, Alexandra Lang, Sarah Sharples, Dominick Shaw
Adherence to treatment in asthma is often poor, particularly in adolescents and children where the condition is most prevalent. Electronic monitoring devices have shown potential for improving inhaler use, yet little research has considered the attitudes of patients towards these devices. We gave seven adolescents with asthma an electronic monitoring device to use for one month and collected their views on important issues including monitoring and data sharing. Our results showed that participants felt positively about using the data to demonstrate responsibility for their condition to both their parents and medical professionals, but expressed concern for the attention the device's appearance could draw to them and their asthma...
January 2017: Applied Ergonomics
Amir Elmekkawi, Kiran More, Jennifer Shea, Christina Sperling, Zelia Da Silva, Michael Finelli, Asaph Rolnitsky, Robert P Jankov
OBJECTIVES: Inhaled nitric oxide (iNO) remains the "gold standard" therapy for hypoxemic respiratory failure in newborns. Despite good quality evidence to guide iNO use in this population, we observed considerable practice variation, particularly in timing and rate of weaning. To promote evidence-based practice, we launched an iNO stewardship program in April 2013. Our objective was to determine whether iNO stewardship led to changes in iNO utilization and weaning. METHODS: We conducted a quality improvement project in an outborn quaternary NICU, targeting improved iNO guideline compliance...
October 2016: Hospital Pediatrics
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