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adherence asthma

Jagdeep Sahota, Douglas S Robinson
A small percentage of patients with asthma have uncontrolled symptoms and frequent exacerbations, despite treatment with inhaled corticosteroids and other agents. It has become clear that different subtypes of this severe, treatment-resistant group exist due to different mechanisms of the disease. All such patients require detailed assessment in specialist centers to characterize the disease and assess treatment adherence. Recently, monoclonal antibodies have become available, which target specific pathways that may contribute to persistent inflammation and asthma exacerbations...
2018: Drug Design, Development and Therapy
Jehan Seret, Magali Pirson, Florence Penson, Hélène Lefebvre, Dan Lecocq
INTRODUCTION: Asthma remains a major public health problem, with 300 million people affected worldwide and a low rate of adherence to treatment. CONTEXT: Few authors have considered one of the determinants of asthmatic patients' adherence to treatment : the accompaniment offered by health care professionals. AIM: To describe the expectations and needs of people living with chronic asthma regarding their accompaniment. METHODS: A descriptive qualitative approach with reasoned sampling...
March 2018: Recherche en Soins Infirmiers
Paul M O'Byrne, J Mark FitzGerald, Eric D Bateman, Peter J Barnes, Nanshan Zhong, Christina Keen, Carin Jorup, Rosa Lamarca, Stefan Ivanov, Helen K Reddel
BACKGROUND: In patients with mild asthma, as-needed use of an inhaled glucocorticoid plus a fast-acting β2 -agonist may be an alternative to conventional treatment strategies. METHODS: We conducted a 52-week, double-blind trial involving patients 12 years of age or older with mild asthma. Patients were randomly assigned to one of three regimens: twice-daily placebo plus terbutaline (0.5 mg) used as needed (terbutaline group), twice-daily placebo plus budesonide-formoterol (200 μg of budesonide and 6 μg of formoterol) used as needed (budesonide-formoterol group), or twice-daily budesonide (200 μg) plus terbutaline used as needed (budesonide maintenance group)...
May 17, 2018: New England Journal of Medicine
Eric D Bateman, Helen K Reddel, Paul M O'Byrne, Peter J Barnes, Nanshan Zhong, Christina Keen, Carin Jorup, Rosa Lamarca, Agnieszka Siwek-Posluszna, J Mark FitzGerald
BACKGROUND: Patients with mild asthma often rely on inhaled short-acting β2 -agonists for symptom relief and have poor adherence to maintenance therapy. Another approach might be for patients to receive a fast-acting reliever plus an inhaled glucocorticoid component on an as-needed basis to address symptoms and exacerbation risk. METHODS: We conducted a 52-week, double-blind, multicenter trial involving patients 12 years of age or older who had mild asthma and were eligible for treatment with regular inhaled glucocorticoids...
May 17, 2018: New England Journal of Medicine
Jacqueline Tudball, Helen K Reddel, Tracey-Lea Laba, Stephen Jan, Anthony Flynn, Michele Goldman, Kirsty Lembke, Elizabeth Roughead, Guy B Marks, Nick Zwar
Objective Out-of-pocket costs strongly affect patient adherence with medicines. For asthma, guidelines recommend that most patients should be prescribed regular low-dose inhaled corticosteroids (ICS) alone, but in Australia most are prescribed combination ICS-long-acting β2-agonists (LABA), which cost more to patients and government. The present qualitative study among general practitioners (GPs) explored the acceptability, and likely effect on prescribing, of lower patient copayments for ICS alone. Methods Semistructured telephone interviews were conducted with 15 GPs from the greater Sydney area; the interviews were transcribed and thematically analysed...
May 14, 2018: Australian Health Review: a Publication of the Australian Hospital Association
Alyssa Oland, Genery D Booster, Bruce G Bender
OBJECTIVE: The present article will review current findings regarding the management of stress in allergic disease. DATA SOURCES: The present review article uses articles and books published between 1995 and 2017. Approximately 85% of sources used were published in the last 10 years and 60% were published in the last 5 years. The majority of sources are peer-reviewed articles. STUDY SELECTIONS: Articles that focused on allergic diseases such as allergic rhinitis, food allergies, urticaria, and allergic asthma were included in the present review...
May 8, 2018: Annals of Allergy, Asthma & Immunology
Gregory T Burg, Ronina Covar, Alyssa A Oland, Theresa W Guilbert
Severe asthma is associated with significant morbidity and is a highly heterogeneous disorder. Severe asthma in adolescence has some unique elements compared with the features of severe asthma a medical provider would see in younger children or adults. A specific focus on psychological issues and adherence highlights some of the challenges in the management of asthma in adolescents. Treatment of adolescents with severe asthma now includes 3 approved biologic phenotype-directed therapies. Therapies available to adults may be beneficial to adolescents with severe asthma...
May 2018: Journal of Allergy and Clinical Immunology in Practice
Alia Yousif, Catherine Lemière, André Cartier, Amélie Forget, Lucie Blais, For The Resp Investigators
OBJECTIVES: 1) To develop Med-Resp, a graphical tool based on prescription refills to measure adherence and use of asthma medications; 2) To test the feasibility of implementing Med-Resp in a hospital outpatient asthma clinic; 3) To explore the effectiveness of Med-Resp to improve medication adherence to asthma controller medications. METHODS: A sequential exploratory design was used: 1) Prototype design in collaboration with respiratory physicians and patients via focus groups; 2) Med-Resp creation based on algorithms developed and applied to prescription refills data recorded in the drug claims database reMed; 3) Feasibility assessment of the implementation of Med-Resp in the outpatient asthma clinic; and 4) Exploration of the effectiveness of Med-Resp through a pre-post design...
May 10, 2018: Journal of Asthma: Official Journal of the Association for the Care of Asthma
Karen MacDonell, Sylvie Naar, Wanda Gibson-Scipio, Jean-Marie Bruzzese, Bo Wang, Aaron Brody
BACKGROUND: Racial and ethnic minority youth have poorer asthma status than white youth, even after controlling for socioeconomic variables. Proper use of asthma controller medications is critical in reducing asthma mortality and morbidity. The clinical consequences of poor asthma management include increased illness complications, excessive functional morbidity, and fatal asthma attacks. There are significant limitations in research on interventions to improve asthma management in racial minority populations, particularly minority adolescents and young adults, although illness management tends to deteriorate after adolescence during emerging adulthood, the unique developmental period beyond adolescence but before adulthood...
May 7, 2018: JMIR Research Protocols
Nicholas D Ross, David McD Taylor, Ashleigh J Sellar, Hayley H Chen, Luke D Plant, Daniel McLean, Paul Berlingeri, Rex Gavan, Tracey J Weiland, Jonathan C Knott, Christine F McDonald
We aimed to determine whether the outpatient management of ED patients with asthma adheres to Australia's Asthma Consensus Guidelines. Adult patients, under treatment for asthma, were administered a validated questionnaire. Data on their outpatient management were collected and analysed descriptively. Of 51 patients, 14 smoked and 35 did not undergo regular GP review. Twenty-one patients had a good understanding of a written asthma action plan although only 15 owned one. Fourteen patients used no preventer medication...
May 3, 2018: Emergency Medicine Australasia: EMA
Hesham Tarraf, Hamdan Al-Jahdali, Abdul Hameed Al Qaseer, Anamarija Gjurovic, Houria Haouichat, Basheer Khassawneh, Bassam Mahboub, Roozbeh Naghshin, François Montestruc, Naser Behbehani
BACKGROUND: Low levels of asthma control are reported in many countries worldwide. Improved knowledge of asthma control in the Middle East and Africa and predictive factors is needed to address this major public healthcare burden. OBJECTIVE: To assess the level of asthma control in patients attending a routine consultation for asthma in the Middle East and North Africa, and the relationship between level of control and patient and disease characteristics, adherence, and quality of life (QoL)...
May 2018: Respiratory Medicine
A M Herrera, P Brand, G Cavada, A Koppmann, M Rivas, J Mackenney, H Sepúlveda, M E Wevar, L Cruzat, S Soto, M A Pérez, A León, I Contreras, C Alvarez, B Walker, C Flores, V Lezana, C Garrido, M E Herrera, A Rojas, C Andrades, E Chala, R A Martínez, M Vega, J A Perillán, H Seguel, I Przybyzsweski
BACKGROUND: Asthma hospitalization rates in Chilean children have increased in the last 14 years, but little is known about the factors associated with this. OBJECTIVE: Describe clinical characteristics of children hospitalized for asthma exacerbation. METHODS: Observational prospective cohort study in 14 hospitals. Over a one-year period, children five years of age or older hospitalized with asthma exacerbation were eligible for inclusion...
April 29, 2018: Allergologia et Immunopathologia
Destaw Fetene Teshome, Amsalu Feleke Demssie, Berihun Megabiaw Zeleke
BACKGROUND: Controlling blood pressure (BP) leads to significant reduction in cardiovascular risks and associated deaths. In Ethiopia, data is scarce about the level and determinants of optimal BP control among hypertensive patients. This study aimed to assess the prevalence and associated factors of optimal BP control among hypertensive patients attending at a district hospital. METHODS: A hospital-based, cross-sectional study was conducted among 392 hypertensive patients who were on treatment and follow-up at a district hospital...
2018: PloS One
Annelies L Robijn, Megan E Jensen, Peter G Gibson, Heather Powell, Warwick B Giles, Vicki L Clifton, Joerg Mattes, Michael J Peek, Helen L Barrett, Sean K Seeho, Leonie K Callaway, Alistair Abbott, John Attia, Peter A Wark, Vanessa E Murphy
OBJECTIVE: Asthma exacerbations and medication non-adherence are significant clinical problems during pregnancy. While asthma self-management education is effective, the number of education sessions required to maximise asthma management knowledge and inhaler technique and whether improvements persist postpartum, is unknown. This paper describes how asthma knowledge, skills, and inhaled corticosteroid (ICS) use have changed over time. METHODS: Data were obtained from three cohorts of pregnant women with asthma recruited in Newcastle, Australia between 2004-2017 (N = 895)...
May 2, 2018: Journal of Asthma: Official Journal of the Association for the Care of Asthma
Bilun Gemicioglu, Hasan Bayram, Arif Cimrin, Oznur Abadoglu, Aykut Cilli, Esra Uzaslan, Hakan Gunen, Levent Akyildiz, Mecit Suerdem, Tevfik Ozlu, Zeynep Misirligil
OBJECTIVE: This study aimed to evaluate the factors that affect asthma control and adherence to treatment in newly diagnosed elderly asthmatics in Turkey compared with younger patients. METHODS: This real-life prospective observational cohort study was conducted at 136 centers. A web-based questionnaire was administered to the patients who were followed up for 12 months. RESULTS: Analysis included 1037 young adult asthma patients (age <65 years) and 79 elderly asthma patients (age ≥65 years)...
May 1, 2018: Journal of Asthma: Official Journal of the Association for the Care of Asthma
Myriam Gagné, Louis-Philippe Boulet, Norma Pérez, Jocelyne Moisan
AIM: To systematically identify the measurement properties of patient-reported outcome instruments (PROs) that evaluate adherence to inhaled maintenance medication in adults with asthma. METHODS: We conducted a systematic review of six databases. Two reviewers independently included studies on the measurement properties of PROs that evaluated adherence in asthmatic participants aged ≥18 years. Based on the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN), the reviewers (1) extracted data on internal consistency, reliability, measurement error, content validity, structural validity, hypotheses testing, cross-cultural validity, criterion validity, and responsiveness; (2) assessed the methodological quality of the included studies; (3) assessed the quality of the measurement properties (positive or negative); and (4) summarised the level of evidence (limited, moderate, or strong)...
April 30, 2018: British Journal of Clinical Pharmacology
Mary Redmayne
Thunderstorm asthma and increased childhood leukemia risk near high-voltage power lines (HVPL) are occurrences whose mechanism of effect is not fully understood. This paper proposes and discusses a key similarity: both thunderstorms and HVPL generate a high enough electrical field in the environment to ionize nearby air and air-borne particles. I argue that the repeatedly demonstrated acute asthma response to pollen-laden air during thunderstorms is largely due to ionization of air-borne allergens, which adhere more readily and in greater quantity in the lungs than non-ionized particles...
April 30, 2018: Electromagnetic Biology and Medicine
Imane Ghanname, Ahmed Chaker, Abha Cherkani Hassani, Laila Herrak, Serge Arnaul Ebongue, Mustapha Laine, Khalid Rahhali, Abdelhak Zoglat, Aida Maria Benitez Rexach, Samir Ahid, Yahia Cherrah
BACKGROUND: The purpose of the study is to describe the profile of patients with asthma and to identify the signifiant risks and the protective factors associated with asthma control. METHODS: A prospective epidemiological study was conducted in three hospitals of Rabat-Morocco and included 396 patients with asthma. Differences in characteristics across the levels of asthma control were compared by the one-way analysis of variance for continuous variables, and chi-square test was used for categorical variables...
April 24, 2018: BMC Pulmonary Medicine
Tunn Ren Tay, Hang Siang Wong, Augustine Tee
OBJECTIVE: Exacerbations are important outcomes in asthma. Risk factors for exacerbations may differ in different populations. Although various demographic and clinical variables were examined in previous studies on exacerbation risks in asthma, important variables such as ethnicity, adherence, and medication titration were not included. This study examined independent predictors of future exacerbations in a multi-ethnic asthma population in Asia, while including the variables of ethnicity, medication adherence, and medication change in our analysis...
April 24, 2018: Journal of Asthma: Official Journal of the Association for the Care of Asthma
Garrett Greene, Richard W Costello, Breda Cushen, Imran Sulaiman, Elaine Mac Hale, Ronan M Conroy, Frank Doyle
OBJECTIVE: We derive a novel model-based metric for effective adherence to medication, and validate it using data from the INhaler Compliance Assessment device (INCATM). This technique employs dose timing data to estimate the threshold drug concentration needed to maintain optimal health. METHODS: The parameters of the model are optimised against patient outcome data using maximum likelihood methods. The model is fitted and validated by secondary analysis of two independent datasets from two remote-monitoring studies of adherence, conducted through clinical research centres of 5 Irish hospitals...
2018: PloS One
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