title: [Deliberate interruptions and changes of dose of inhaled corticosteroids by asthma patients: "a community pharmacy study"].
abstract: BACKGROUND
  Adherence to inhaled corticosteroids (ICS) remains a major issue for asthma management, even among patients receiving a regular prescription from their doctor. The frequency of deliberate interruption of ICS, and of spontaneous changes of dose, were studied in a population of asthma patients recruited in community pharmacies.
  
  
  METHODS
  Asthma patients (aged 18-50) recruited in community pharmacies reported in self-administered questionnaires their spontaneous interruptions and changes of doses of ICS during the past 3 months. The characteristics of patients who interrupted their therapy or who modified the dose were compared with other patients.
  
  
  RESULTS
  The studied population included 252 patients (mean age 35 year-old, females: 59%), of whom 62% had inadequately controlled asthma. Among these patients, 25% had interrupted ICS therapy during the past 3 months, while 21% spontaneously changed the dose. The most reported reason for interrupting ICS was the cessation of symptoms (50%). In multivariate analysis, interrupting ICS was mainly associated with inadequate asthma control (OR=3.1, 95% CI 1.5-6.4), while the strongest association with changing ICS doses was the patients' perception of asthma as a concern in their lives (OR=3.2, 95% CI 1.2-8.4).
  
  
  CONCLUSIONS
  These results underline a poor understanding of the purpose of ICS therapy by patients. They also highlight the need of therapeutic education to improve the management of the disease.
authors.affiliation: UMR 5558-CNRS, unité de pharmacoépidémiologie, faculté d'odontologie, 11, rue Guillaume-Paradin, 69372 Lyon cedex 08, France.
authors.forename: L
authors.initials: L
authors.lastname: Laforest
authors.affiliation: UMR 5558-CNRS, unité de pharmacoépidémiologie, faculté d'odontologie, 11, rue Guillaume-Paradin, 69372 Lyon cedex 08, France; Service de pneumologie, hôpital de la Croix-Rousse, HCL, 69004 Lyon, France. Electronic address: eric.van-ganse@univ-lyon1.fr.
authors.forename: É
authors.initials: É
authors.lastname: Van Ganse
authors.affiliation: Service de pneumologie, hôpital de la Croix-Rousse, HCL, 69004 Lyon, France.
authors.forename: G
authors.initials: G
authors.lastname: Devouassoux
authors.affiliation: 69300 Caluire, France.
authors.forename: G
authors.initials: G
authors.lastname: Chatté
authors.affiliation: UMR 5558-CNRS, unité de pharmacoépidémiologie, faculté d'odontologie, 11, rue Guillaume-Paradin, 69372 Lyon cedex 08, France.
authors.forename: C
authors.initials: C
authors.lastname: Tamberou
authors.affiliation: UMR 5558-CNRS, unité de pharmacoépidémiologie, faculté d'odontologie, 11, rue Guillaume-Paradin, 69372 Lyon cedex 08, France.
authors.forename: M
authors.initials: M
authors.lastname: Belhassen
authors.affiliation: Pharmakeion, 69009 Lyon, France.
authors.forename: G
authors.initials: G
authors.lastname: Chamba
mesh_terms: D000293:Adolescent; D000328:Adult; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D001249:Asthma / Q000188:drug therapy* / Q000523:psychology; D004363:Drug Utilization; D005260:Female; D006801:Humans; D008297:Male; D010349:Patient Compliance; D010353:Patient Education as Topic; D010594:Pharmacies / Q000706:statistics & numerical data*; D012649:Self Concept; D057566:Self Report; D055815:Young Adult
chemical_list: D018927:Anti-Asthmatic Agents
keywords: Adherence; Asthma; Asthma control; Asthme; Community pharmacies; Contrôle de l’asthme; Corticoïdes inhalés; Inhaled corticosteroids; Observance; Pharmacie