RT Journal Article
SR Electronic
T1 Excess inhaled corticosteroid adherence may be a marker of uncontrolled asthma
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P276
VO 42
IS Suppl 57
A1 Richard Martin
A1 David Price
A1 Jerry Krishnan
A1 Jonathan D. Campbell
A1 Leif Bjermer
A1 Andrew McIvor
A1 Gary Wong
A1 Marc Miravitlles
A1 Alison Chisholm
A1 Annie Burden
YR 2013
UL http://erj.ersjournals.com/content/42/Suppl_57/P276.abstract
AB Background: The relationship between adherence to inhaled corticosteroids (ICS) in excess of 100% and asthma control is unclear.Methods: The Respiratory Effectiveness Group conducted a real-life study using a US healthcare database to examine the association between ICS medication possession ratio (MPR) >100% (a proxy measure of excess adherence) and asthma control. Eligible patients were 12–80 yrs and initiated ICS as hydrofluoroalkane beclometasone (n=2578) or fluticasone (n=7734). Over the one-year period following ICS initiation, MPR was calculated as the number of days’ supply of ICS/365 x 100% (categorized as ≤100%; >100%). Measures of asthma control consisted of severe exacerbations (unscheduled hospital admission or ER attendance for asthma or an acute course of oral corticosteroids) and Risk Domain Asthma Control (RDAC: no admission, ER attendance, or outpatient hospital attendance for asthma; no acute oral corticosteroids prescriptions; no consultation, hospital admission, or ER attendance for a lower respiratory tract infection requiring antibiotics, and no hospital admission or ER attendance for lower respiratory reasons) during the same period.Results: MPR>100% occurred in 7.2% of patients (n=742). Severe exacerbations were more common and RDAC attainment lower in patients with MPR >100% than in patients with MPR ≤100% (see table).View this table:Conclusions: In clinical practice, adherence to ICS in excess of the label-defined dosing interval appears to be a marker of poorer asthma control. A MPR >100% may be a simple tool to identify patients in need of more intensive evaluation.