title: Inhaler device, administration technique, and adherence to inhaled corticosteroids in patients with asthma.
abstract: OBJECTIVE
  To compare inhaled corticosteroid (ICS) inhaler type with user technique and ICS medication adherence among adults with asthma.
  
  
  METHODS
  We classified 270 adults into two groups by ICS device type: metered-dose inhaler (MDI) or dry powder inhaler (DPI). Inhaler technique was assessed using standardised checklists. Medication adherence was evaluated using the Medication Adherence Report Scale (MARS). Differences in inhaler technique and MARS score among patients using MDIs versus DPIs were evaluated.
  
  
  RESULTS
  Univariate analysis showed no difference in technique scores between the groups (p=0.46), but better ICS adherence among DPI users (p=0.001). In multivariable analysis, DPI use remained significantly associated with higher rates of adherence (OR 2.2; 95% CI 1.2 to 3.8) but not with inhaler technique (-0.2; 95% CI -0.5 to 0.1) after adjusting for potential confounders.
  
  
  CONCLUSIONS
  Type of inhaler device appears to be associated with adherence to asthma controller medications. Prospective studies are needed to elucidate further the potential effect of the type of ICS delivery device on asthma self-management.
authors: Department of Pediatrics, Mount Sinai School of Medicine, New York, NY, USA. aroy@eriefamilyhealth.org
authors: Angkana
authors: A
authors: Roy
authors: Kayleigh
authors: K
authors: Battle
authors: Linda
authors: L
authors: Lurslurchachai
authors: Ethan A
authors: EA
authors: Halm
authors: Juan P
authors: JP
authors: Wisnivesky
mesh_terms: D000280:Administration, Inhalation; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage*; D001249:Asthma / Q000188:drug therapy*; D058995:Dry Powder Inhalers; D005260:Female; D006801:Humans; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D010349:Patient Compliance; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D000305:Adrenal Cortex Hormones