title: Effectiveness of an asthma integrated care program on asthma control and adherence to inhaled corticosteroids.
abstract: OBJECTIVE
  To measure the effectiveness of an integrated care program for individuals with asthma aged 12-45 years, on asthma control and adherence to inhaled corticosteroids (ICS).
  
  
  METHODS
  Researchers used a theoretical model to develop the program and assessed effectiveness at 12 months, using a pragmatic controlled clinical trial design. Forty-two community pharmacists in Quebec, Canada recruited participants with either uncontrolled or mild-to-severe asthma. One group was exposed to the program; another received usual care. Asthma control was measured with the Asthma Control Questionnaire; ICS adherence was assessed with the Morisky medication adherence scale and the medication possession ratio. Program effectiveness was assessed with an intention-to-treat approach using multivariate generalized estimating equation models.
  
  
  RESULTS
  Among 108 exposed and 241 non-exposed, 52.2% had controlled asthma at baseline. At 12-months, asthma control had improved in both groups but the interaction between study groups and time was not significant (p = 0.09). The proportion of participants with good ICS adherence was low at baseline. Exposed participants showed improvement in adherence and the interaction between study groups and time was significant (p = 0.02).
  
  
  CONCLUSIONS
  An integrated intervention, with healthcare professionals collaborating to optimize asthma control, can improve ICS adherence.
authors.affiliation: a Faculty of Pharmacy , Laval University , Quebec City , Québec , Canada .
authors.forename: Line
authors.initials: L
authors.lastname: Guénette
authors.forename: Marie-Claude
authors.initials: MC
authors.lastname: Breton
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Grégoire
authors.forename: Marie-Sophie
authors.initials: MS
authors.lastname: Jobin
authors.forename: Yves
authors.initials: Y
authors.lastname: Bolduc
authors.forename: Louis-Philippe
authors.initials: LP
authors.lastname: Boulet
authors.forename: Eileen
authors.initials: E
authors.lastname: Dorval
authors.forename: Jocelyne
authors.initials: J
authors.lastname: Moisan
mesh_terms: D000280:Administration, Inhalation; D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000627:therapeutic use*; D000328:Adult; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy*; D002648:Child; D004777:Environment; D005260:Female; D015438:Health Behavior; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D015397:Program Evaluation; D011792:Quebec; D012648:Self Care / Q000379:methods*; D012720:Severity of Illness Index; D055815:Young Adult; D016903:Drug Monitoring
chemical_list: D000305:Adrenal Cortex Hormones; D018927:Anti-Asthmatic Agents
keywords: Asthma; asthma control; inhaled corticosteroids; integrated care; medication adherence; patient education