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Medication adherence and the risk of severe asthma exacerbations: a systematic review

Marjolein Engelkes, Hettie M. Janssens, Johan C. de Jongste, Miriam C.J.M. Sturkenboom, Katia M.C. Verhamme
European Respiratory Journal 2014; DOI: 10.1183/09031936.00075614
Marjolein Engelkes
1Dept of Medical Informatics, Erasmus University, Rotterdam, The Netherlands
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  • For correspondence: m.engelkes@erasmusmc.nl
Hettie M. Janssens
2Dept of Pediatrics/Respiratory Medicine, Erasmus University/Sophia Children’s Hospital, Rotterdam, The Netherlands
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Johan C. de Jongste
2Dept of Pediatrics/Respiratory Medicine, Erasmus University/Sophia Children’s Hospital, Rotterdam, The Netherlands
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Miriam C.J.M. Sturkenboom
1Dept of Medical Informatics, Erasmus University, Rotterdam, The Netherlands
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Katia M.C. Verhamme
1Dept of Medical Informatics, Erasmus University, Rotterdam, The Netherlands
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Abstract

The benefits of drug therapy for asthma have been well established, but adherence to treatment is poor, and this might be associated with an increased risk of asthma exacerbations. The aim of this study was to review the literature on the association between adherence to asthma controller treatment and risk of severe asthma exacerbations in children and adults.

A systematic literature search was performed in PubMed, Embase and Web of Science, from inception until January 2014. Studies were included if data on the association between medication adherence and severe asthma exacerbations were presented. Quality was assessed using a modified version of the Newcastle–Ottawa Scale.

The search yielded 2319 unique publications, of which 23 met the inclusion criteria and underwent data extraction and quality scoring. High levels of heterogeneity across studies with regard to adherence and exacerbation measurements, designs and analysis precluded a formal meta-analysis. Although effect measures varied widely, good adherence was associated with fewer severe asthma exacerbations in high-quality studies.

Good adherence tended to be associated with lower risk of severe asthma exacerbations. Future studies should use standardised methodology to assess adherence and exacerbations, and should consider inhaler competence.

Abstract

High-quality studies indicated that better adherence is associated with fewer severe asthma exacerbations http://ow.ly/BU6ro

  • Received November 25, 2013.
  • Accepted August 27, 2014.
  • ©ERS
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Medication adherence and the risk of severe asthma exacerbations: a systematic review
Marjolein Engelkes, Hettie M. Janssens, Johan C. de Jongste, Miriam C.J.M. Sturkenboom, Katia M.C. Verhamme
European Respiratory Journal Jan 2014, erj00756-2014; DOI: 10.1183/09031936.00075614

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Medication adherence and the risk of severe asthma exacerbations: a systematic review
Marjolein Engelkes, Hettie M. Janssens, Johan C. de Jongste, Miriam C.J.M. Sturkenboom, Katia M.C. Verhamme
European Respiratory Journal Jan 2014, erj00756-2014; DOI: 10.1183/09031936.00075614
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