title: Open adherence monitoring using routine data download from an adaptive aerosol delivery nebuliser in children with cystic fibrosis.
abstract: BACKGROUND
  Adaptive aerosol delivery (AAD) nebuliser devices can reduce treatment times whilst enabling adherence to be monitored using inbuilt data logs. Using one such device, we have monitored nebulised antibiotic adherence in children with Cystic Fibrosis (CF).
  
  
  METHODS
  In CF children infected with Pseudomonas aeruginosa, downloaded data from an AAD device was used to calculate morning, evening and overall monthly adherence to antibiotic therapy over a year.
  
  
  RESULTS
  Overall monthly adherence to nebulised antibiotic therapy in 28 children was maintained between 60 and 70% over the year. Considerable variation in adherence, both between and within patients, was evident (Mean [SD] coefficient of variation, 37[44]%). Evening adherence (75[37]%) was better than morning adherence (58[34]%: p=0.012). Treatment regimens were changed in 8/28 patients based on adherence data.
  
  
  CONCLUSIONS
  Routine adherence monitoring can be implemented in an outpatient setting. Using this type of information it is possible to identify which aspects of treatment can be improved and to work together with families to individualize treatments.
authors.affiliation: Respiratory Unit, Alder Hey Children's NHS Foundation Trust, Eaton Rd, Liverpool, L12 2AP, UK. mcnamp@liv.ac.uk
authors.forename: Paul S
authors.initials: PS
authors.lastname: McNamara
authors.forename: Pamela
authors.initials: P
authors.lastname: McCormack
authors.forename: Alison J
authors.initials: AJ
authors.lastname: McDonald
authors.forename: Louisa
authors.initials: L
authors.lastname: Heaf
authors.forename: Kevin W
authors.initials: KW
authors.lastname: Southern
mesh_terms: D000280:Administration, Inhalation; D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D002648:Child; D002675:Child, Preschool; D003091:Colistin / Q000008:administration & dosage; D003550:Cystic Fibrosis / Q000150:complications*; D016903:Drug Monitoring / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D055118:Medication Adherence; D009330:Nebulizers and Vaporizers; D011552:Pseudomonas Infections / Q000150:complications* / Q000188:drug therapy*; D011550:Pseudomonas aeruginosa / Q000187:drug effects*; D012189:Retrospective Studies
chemical_list: D000900:Anti-Bacterial Agents; D003091:Colistin