Abstract
Introduction: Nonadherence to prescribed medication significantly contributes to poor asthma control. Electronic monitoring devices (Smartinhalers®) have been used to monitor children's adherence and have shown that even when monitored over half of patients had poor adherence of <80% (ERJ1915;46 (suppl 59),OA4775). From a clinical perspective it is plausible that although patients do not adhere fully to their inhalers they may take at least once dose per day.
Aims: To assess patterns of nonadherence in children with severe asthma including the proportion of days when preventer inhaler doses were taken once daily.
Methods: Secondary analysis was conducted using SmartInhaler® data. Children's adherence to preventer inhalers was monitored in 91 participants (median age=12 years old; range 5-17), over a period of up to 200 days (median 92 days). Participants were prescribed at least one puff of their inhaler twice daily.
Results: The median adherence to the prescribed dose was 74% (range 21-99%). No patients took their inhalers as prescribed every day. However, if we apply a cut of >80% adherence, then 52% would be classed as being nonadherent. When assessing once daily use only 12% took their inhaler at least once daily every day. When applying a cut of >80% of the time one third of patients (32%) were still nonadherent to at least a once daily dose.
Conclusions: Children take their inhalers less than prescribed, however around two thirds take it at least once per day (>80% of the time). We do not know how or whether a once a daily treatment might affect nonadherence as part of an adherence support package. Further studies investigating the reasons for nonadherence and the acceptability of once daily inhalers are now justified.
- Copyright ©the authors 2016