Factors affecting adherence with treatment advice in a clinical trial of patients with severe asthma
| Autor: | James Lordan, Catherine E. Hanratty, Stephen J. Fowler, Robert Niven, Peter H. Howarth, Ian D. Pavord, Ratko Djukanovic, Douglas C. Cowan, Timothy C. Hardman, Douglas S. Robinson, Rekha Chaudhuri, David F. Choy, Joseph R. Arron, John Busby, Peter Bradding, Cecile T.J. Holweg, Christopher E. Brightling, Liam G Heaney, Samantha Walker, Andrew Menzies-Gow, Tim Harrison, AH Mansur, John G. Matthews, Ashley Woodcock |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty Multivariate analysis business.industry Attendance MEDLINE Ethnic group Asthma Advice (programming) Clinical trial Adrenal Cortex Hormones Internal medicine medicine Ethnicity Biomarker (medicine) Humans Single-Blind Method Disease management (health) business Minority Groups |
| Zdroj: | investigators for the MRC Refractory Asthma Stratification Program 2021, ' Factors affecting adherence with treatment advice in a clinical trial of patients with severe asthma ', The European respiratory journal . https://doi.org/10.1183/13993003.00768-2021 Busby, J, Matthews, J G, Chaudhuri, R, Pavord, I D, Hardman, T C, Arron, J R, Bradding, P, Brightling, C E, Choy, D F, Cowan, D C, Djukanovic, R, Hanratty, C E, Harrison, T W, Holweg, C T, Howarth, P H, Fowler, S J, Lordan, J L, Mansur, A H, Menzies-Gow, A, Niven, R M, Robinson, D S, Walker, S M, Woodcock, A & Heaney, L G 2022, ' Factors affecting adherence with treatment advice in a clinical trial of patients with severe asthma ', European Respiratory Journal, vol. 59, no. 4, 2100768 . https://doi.org/10.1183/13993003.00768-2021 |
| DOI: | 10.1183/13993003.00768-2021 |
| Popis: | Background: understanding why patients with severe asthma do not follow healthcare provider (HCP) advice to adjust treatment is critical to achieving personalised disease management.Methods: we reviewed patient choice to follow HCP advice to adjust asthma treatment in a randomised, controlled, single-blind (study participant), multi-centre, parallel group 48-week clinical study comparing biomarker directed treatment adjustment to standard care in severe asthma.Results: of 1572 treatment advisories (301 participants), instructions were followed in 1377 cases (87.6%). Patients were more likely to follow advice to remain on treatment (96.7%) than to either reduce (70.3%) or increase (67.1%) their treatment, with 64% of patients following all treatment advice. Multivariate analysis associated belonging to an ethnic minority group (OR: 3.10; 95% CI: 1.68, 5.73) and prior study medication changes (≥2 OR: 2.77, 95% CI: 1.51, 5.10) with failure to follow treatment advice. In contrast, emergency room attendance in the prior year (OR: 0.54, 95% CI: 0.32, 0.92) was associated with following treatment advice. The largest effect was seen with transition onto or off oral corticosteroids (OR: 29.28; 95% CI: 16.07, 53.36) when compared to those requested to maintain treatment. Centre was also an important determinant regarding the likelihood of patients to follow treatment advice.Conclusions: belonging to an ethnic minority group and multiple prior treatment adjustments were associated with not following HCP treatment advice. Patients also responded differently to HCP advice across UK specialist centres. These findings have implications for generalisability for models of care in severe asthma and require further focussed studies. |
| Databáze: | OpenAIRE |
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