| Autor: |
G. Rumi, J.M. Foster, E. Rapsomaniki, C. Columbro, Janwillem W. H. Kocks, R. Contiguglia, F. Braido, G. Valenti, Giorgio Walter Canonica, M.A. de Blas, Niels H. Chavannes |
| Rok vydání: |
2018 |
| Předmět: |
|
| Zdroj: |
Optimising inhalers for optimal asthma control. |
| DOI: |
10.1136/thorax-2018-212555.329 |
| Popis: |
Introduction and objective Electronic inhalers providing reminders and adherence feedback have improved adherence to asthma controller medication in clinical trials. We investigated a community implementation of the Turbu+™ programme, designed to support adherence to budesonide/formoterol (BUD/FORM, Symbicort®) Turbuhaler®. Methods Asthma patients prescribed BUD/FORM maintenance therapy (1-BID or 2-BID) or maintenance and reliever therapy (1-BID+as needed or 2-BID+as needed) received training on Turbu+™ in secondary care centres across Italy. An electronic device attached to their inhaler for ≥90 days securely uploaded adherence data to a smartphone app enabling patients to view their controller use. Average medication adherence was calculated based on maintenance regimens (2 puffs/day for 1-BID regimens, 4 puffs/day for 2-BID regimens) and defined as proportion of daily maintenance inhalations taken as prescribed (number recorded actuations per day/number maintenance puffs prescribed per day) averaged over the monitoring period. Proportion of adherent days was defined as the proportion of days that all prescribed maintenance doses were taken in a given day. A Wilcoxon test compared proportion of adherent days between patients in the maintenance vs maintenance and reliever treatment regimens of a given dose (1-BID or 2-BID). Results In 316 patients, mean (±SD) number of days monitored was 156.9 (±53.7): 1-BID, 158.8 (±50.9); 1-BID+as needed, 154.2 (±53.2); 2-BID, 149.4 (±62.7) and 2-BID+as needed, 162.3 (±53.5). Median (IQR) number of doses/day were: 1-BID, 2 doses (1–2); 1-BID+as needed, 2 doses (1–2); 2-BID, 4 doses (2–4) and 2-BID+as needed, 4 doses (2–4). Average medication adherence was 71% overall and similar across treatment groups (figure 1). Proportion of adherent days was 57% of days overall and higher with maintenance and reliever therapy (1-BID+as needed vs 1-BID; p 12 doses/day) were low (˜0.05% person-days). Conclusion Observed controller adherence rate of patients in the Turbu+™ programme (71%) was higher than that previously reported in Italy,1 although comparisons between this small study in selected sites and a large unselected national survey are difficult. Further prospective research of the Turbu+™ programme will determine its contribution to improved adherence. Reference AIFA. http://www.aifa.gov.it/ |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
|
