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Inhaler adherence

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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
#1
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/28730933/drug-delivery-to-the-lungs-challenges-and-opportunities
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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...
June 22, 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
#9
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
#10
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
#11
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
#12
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
https://www.readbyqxmd.com/read/28610667/why-choose-tiotropium-for-my-patient-a-comprehensive-review-of-actions-and-outcomes-versus-other-bronchodilators
#13
REVIEW
David M Halpin, Alan G Kaplan, Richard K Russell
PURPOSE: Chronic obstructive pulmonary disease (COPD) and asthma are leading causes of morbidity and mortality. This narrative review provides an appraisal of the pharmacological and clinical characteristics of tiotropium in COPD and asthma, and examines how these compare with other long-acting bronchodilators. The evidence base is placed into context by relating it to factors affecting clinicians' choice of therapy. MAIN FINDINGS: Desirable attributes of a long-acting muscarinic antagonist (LAMA) maintenance therapy include effective pharmacological bronchodilation, improved lung function, exacerbation efficacy, and positive effects on symptom control, exercise capacity and quality of life across a broad patient population...
July 2017: Respiratory Medicine
https://www.readbyqxmd.com/read/28597176/self-management-research-of-asthma-and-good-drug-use-smaragd-study-a-pilot-trial
#14
Esther Kuipers, Michel Wensing, Peter de Smet, Martina Teichert
Background Community pharmacists play an important role in supporting patients for optimal drug use. Objective To assess the effectiveness of monitoring in asthma patients with inhaled corticosteroids (ICS) on disease control. Setting Asthma patients using ICS were invited from two intervention (IG) and two control pharmacies (CG). Method Participating patients completed questionnaires at the study start and at 6-month follow-up, including the Control of Allergic Rhinitis and Asthma Test (CARAT) questionnaire...
June 9, 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/28594249/a-pilot-randomized-trial-of-school-based-administration-of-inhaled-corticosteroids-for-at-risk-children-with-asthma
#15
Cherise B Harrington, Eric Langhans, Deborah Q Shelef, Molly Savitz, Colleen Whitmore, Stephen J Teach
OBJECTIVE: To investigate whether high adherence to inhaled corticosteroids (ICS) among disadvantaged urban public school children on public insurance with persistent asthma is achievable by having school nurses administer morning doses on each day that school is in session. DESIGN/METHODS: This was a pilot prospective randomized clinical trial of home versus school nurse-administered ICS among children on Medicaid enrolled in grades K-8. The primary outcome was the proportion of expected morning doses of ICS given to the intervention group in school over the 60-day treatment period...
June 8, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/28586296/asthma-control-and-disease-burden-in-patients-with-asthma-and-allergic-comorbidities
#16
Lulu K Lee, Engels Obi, Brandee Paknis, Abhishek Kavati, Bradley Chipps
OBJECTIVE: To assess asthma control and associations with health-related quality of life (HRQoL) and economic outcomes among patients with asthma and allergic comorbidities treated with inhaled corticosteroids (ICS) and long-acting beta-agonists (LABA) combination therapy. METHODS: Data from the 2011-2013 US National Health and Wellness Survey were used to identify patients with asthma currently treated with ICS and LABA combination therapy (N = 1923). Patients were included if they self-reported a physician diagnosis of asthma and at least one allergic/asthma-related comorbid condition (e...
June 6, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/28548868/inhaled-corticosteroid-prescribing-in-a-pediatric-emergency-department-sustained-success-and-prescription-filling-rates
#17
Sarah Nicole Adams, Mary Abel, Dustin Fowler, Jennifer Braden, Myla D Ebeling, Annie N Simpson, M Olivia Titus, Annie Lintzenich Andrews
OBJECTIVE: To determine if improvement in Inhaled Corticosteroid (ICS) prescribing in the pediatric emergency department (PED) can be sustained after transition from intense intervention to low-intervention phase, and to determine ICS fill rates. METHODS: A Quality Improvement (QI) project began in Aug 2012. Results through Feb 2014 were previously published. In Feb 2014 interventions were scaled back to determine the sustainability of QI success. Eligible patients included children aged 2-17 seen in the PED for asthma between Feb 2014 and Sept 2016...
May 26, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/28535964/income-is-an-independent-risk-factor-for-worse-asthma-outcomes
#18
Juan Carlos Cardet, Margee Louisias, Tonya S King, Mario Castro, Christopher D Codispoti, Ryan Dunn, Linda Engle, B Louise Giles, Fernando Holguin, John J Lima, Dayna Long, Njira Lugogo, Sharmilee Nyenhuis, Victor E Ortega, Sima Ramratnam, Michael E Wechsler, Elliot Israel, Wanda Phipatanakul
BACKGROUND: Socioeconomic status (SES) is associated with asthma morbidity in observational studies, but the factors underlying this association are uncertain. OBJECTIVE: We investigated whether 3 SES correlates-low income, low education, and high perceived stress-were independent risk factors for treatment failure and asthma exacerbations in the context of a randomized controlled trial. METHODS: The effect of low SES (household income of <$50,000/y and household educational level of less than a Bachelor's degree) and high perceived stress (defined as a score of >20 on a perceived stress scale) on asthma morbidity was analyzed in 381 participants by using Poisson regression models...
May 20, 2017: Journal of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/28526801/urging-europe-to-put-non-adherence-to-inhaled-respiratory-medication-higher-on-the-policy-agenda-a-report-from-the-first-european-congress-on-adherence-to-therapy
#19
EDITORIAL
Job F M van Boven, Federico Lavorini, P N Richard Dekhuijzen, Francesco Blasi, David B Price, Giovanni Viegi
No abstract text is available yet for this article.
May 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/28513515/relationship-between-knowledge-and-quality-of-asthma-care-among-physicians-in-south-west-nigeria
#20
B Adeniyi, O Ilesanmi, D Obaseki, O Desalu, B Betiku, G Erhabor
INTRODUCTION: Adequate knowledge of asthma management and adherence to international guidelines are known to increase the quality of care offered by Physicians. We conducted this study to assess the level of asthma knowledge and quality of care among physicians practicing in Ondo State. METHODS: We conducted a cross sectional survey of 96 physicians from various specialties participating in a continuous professional development (CPD) lecture using adapted questionnaires...
May 2017: Nigerian Journal of Clinical Practice
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