title: Pharmaceutical care for patients with persistent asthma: assessment of treatment compliance and use of inhaled medications.
abstract: OBJECTIVE
  To evaluate treatment compliance and use of inhaled medications of patients with asthma receiving complementary pharmaceutical care.
  
  
  METHODS
  A controlled prospective parallel study involving a study group and a control group. We selected 60 patients with persistent asthma and using metered-dose inhalers (MDIs), dry powder inhalers (DPIs) or both. The patients were evaluated three times over 60 days. Instructions were provided to the patients in the study group at all visits but only at the first visit to those in the control group. The patients using < 80% or > 120% of the total number of prescribed doses were classified as noncompliant. The inhalation technique was quantified by a scoring system. A satisfactory technique was defined as a score higher than 7 (maximum, 9) for MDIs and higher than 4 (maximum, 5) for DPIs.
  
  
  RESULTS
  The final study sample comprised 28 study group patients and 27 control group patients, of whom 18 (64.3%) and 20 (74.7%), respectively, were considered treatment compliant. From the first to the third visits, there were increases, in the study and control groups, in the median MDI-use score (from 3 [range, 0-5] to 8 [range, 8-9]; p < 0.001; and from 5 [range, 2-6] to 7 [range, 6-8]), as well as in the median DPI-use score (from 3 [range, 2-4] to 5 [range, 4-5] and from 3 [range, 2-4] to 4 [range, 3-5]).
  
  
  CONCLUSIONS
  The counseling provided by the pharmacist to the patient was important to assist in the implementation of the appropriate inhalation technique, especially for MDI use.
authors.affiliation: Department of Pharmacy, Hospital das Clinicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil.
authors.forename: Daiane de Oliveira
authors.initials: Dde O
authors.lastname: Santos
authors.forename: Maria Cleusa
authors.initials: MC
authors.lastname: Martins
authors.forename: Sonia Lucena
authors.initials: SL
authors.lastname: Cipriano
authors.forename: Regina Maria Carvalho
authors.initials: RM
authors.lastname: Pinto
authors.forename: Alberto
authors.initials: A
authors.lastname: Cukier
authors.forename: Rafael
authors.initials: R
authors.lastname: Stelmach
mesh_terms: D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage*; D001249:Asthma / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008297:Male; D036501:Metered Dose Inhalers; D008875:Middle Aged; D010353:Patient Education as Topic / Q000592:standards; D010593:Pharmaceutical Services / Q000592:standards*; D011208:Powders; D011446:Prospective Studies; D055815:Young Adult; D016903:Drug Monitoring
chemical_list: D018927:Anti-Asthmatic Agents; D011208:Powders