The relationship between prescribed and delivered doses of inhaled corticosteroids in adult asthmatics.
A model was developed to estimate the impact of adherence and inhalation technique over time on delivered doses of inhaled corticosteroids (ICS) for asthmatics using metered-dose inhalers (MDIs) and dry powder inhalers (DPIs). Factors affecting inhalation technique include ongoing training, inhalation device, spacer use (with MDIs), and natural ability. Model parameters were derived from a literature review or were estimated from clinical experience. Analyses demonstrated that most patients receive a fraction of prescribed ICS doses over time. The model may be used to better understand the impact of increasing ICS dosages and to estimate the likelihood of patients being underdosed.
Luskin
A T
AT
Respiratory Institute, Dean Medical Center and University of Wisconsin, Madison 53590, USA. ssluskin@msn.com
Bukstein
D
D
Ben-Joseph
R
R
D000280:Administration, Inhalation; D000328:Adult; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D001249:Asthma / Q000188:drug therapy*; D006801:Humans; D008962:Models, Theoretical; D009330:Nebulizers and Vaporizers; D010349:Patient Compliance; D013256:Steroids
D018927:Anti-Asthmatic Agents; D000893:Anti-Inflammatory Agents; D013256:Steroids