title: The relationship between clinical outcomes and medication adherence in difficult-to-control asthma.
abstract: Medication non-adherence and the clinical implications in difficult-to-control asthma were audited. Prescription issue data from 115 patients identified sub-optimal adherence (<80%) in 65% of patients on inhaled corticosteroids (ICS) or combined ICS/long-acting β2 agonist (LABA). In those using separate ICS and LABA, adherence to LABA (50%) was significantly better than to ICS (14.3%). Patients with sub-optimal ICS adherence had reduced FEV(1) and higher sputum eosinophil counts. Adherence ratio was an independent predictor of previous ventilation for acute severe asthma (p=0.008). The majority of patients with difficult-to-control asthma are non-adherent with their asthma medication. Non-adherence is correlated with poor clinical outcomes.
authors.affiliation: Department of Respiratory Medicine, Glenfield Hospital, Leicester, UK. anna.murphy@uhl-tr.nhs.uk
authors.forename: Anna C
authors.initials: AC
authors.lastname: Murphy
authors.forename: Amandine
authors.initials: A
authors.lastname: Proeschal
authors.forename: Christopher E
authors.initials: CE
authors.lastname: Brightling
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Wardlaw
authors.forename: Ian
authors.initials: I
authors.lastname: Pavord
authors.forename: Peter
authors.initials: P
authors.lastname: Bradding
authors.forename: Ruth H
authors.initials: RH
authors.lastname: Green
mesh_terms: D000280:Administration, Inhalation; D058666:Adrenergic beta-2 Receptor Agonists / Q000008:administration & dosage / Q000627:therapeutic use; D000328:Adult; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D001249:Asthma / Q000188:drug therapy* / Q000503:physiopathology; D003695:Delivery of Health Care / Q000706:statistics & numerical data; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D005541:Forced Expiratory Volume / Q000187:drug effects; D005938:Glucocorticoids / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D016896:Treatment Outcome; D016903:Drug Monitoring
chemical_list: D058666:Adrenergic beta-2 Receptor Agonists; D018927:Anti-Asthmatic Agents; D005938:Glucocorticoids