Type

Journal Article

Authors

Richard W Costello
Richard B Reilly
Sheila A Ryder
Isabelle Killane
Matshediso Mokoka
Breda Cushen
Shona D'Arcy
Viliam Rapcan
Susan M O'Dwyer
Fiona Boland
and 3 others

Subjects

Medicine & Nursing

Topics
life clinical outcomes clinical asthma patient outcomes medicine and health sciences adherence lung function digital therapy inhaler

A Method to Calculate Adherence to Inhaled Therapy That Reflects the Changes in Clinical Features of Asthma. (2016)

Abstract Rationale Currently studies on adherence to inhaled medications report Average Adherence over time. This measure does not account for variations in the interval between doses nor for errors in inhaler use. Objectives We investigated whether adherence calculated as a single Area Under the concentration-time Curve (AUC) measure, incorporating the interval between doses and inhaler technique, was more reflective of patient outcomes than current methods of assessing adherence. Methods We attached a digital audio device (INCATM) to a dry powder inhaler. This recorded when the inhaler was used and analysis of the audio data indicated if the inhaler had been used correctly. These aspects of inhaler use were combined to calculate adherence over time, as an AUC measure. Over a 3 month period a cohort of asthma patients were studied. Adherence to a twice-daily inhaler preventer therapy using this device and clinical measures were assessed. Measurements and Results Recordings from 239 patients with severe asthma were analysed. Average Adherence, based on the dose counter was 84.4%, whereas the ratio of expected to observed accumulated AUC, Actual Adherence, was 61.8% (p<0.01). Of all adherence measures, only adherence calculated as AUC reflected changes in asthma quality of life, beta agonist reliever use and PEF, over the three months (p<0.05 compared to other measures of adherence). Conclusion Adherence that incorporates the interval between doses and inhaler technique, and calculated as AUC, is more reflective of changes in quality of life and lung function than the currently used measures of adherence.
Collections Ireland -> Royal College of Surgeons in Ireland -> PubMed
Ireland -> Royal College of Surgeons in Ireland -> Medicine Articles
Ireland -> Royal College of Surgeons in Ireland -> Department of Medicine

Full list of authors on original publication

Richard W Costello, Richard B Reilly, Sheila A Ryder, Isabelle Killane, Matshediso Mokoka, Breda Cushen, Shona D'Arcy, Viliam Rapcan, Susan M O'Dwyer, Fiona Boland and 3 others

Experts in our system

1
Richard W Costello
Royal College of Surgeons in Ireland
Total Publications: 62
 
2
Richard Reilly
Trinity College Dublin
Total Publications: 183
 
3
Sheila A Ryder
Royal College of Surgeons in Ireland
Total Publications: 5
 
4
Isabelle Killane
Royal College of Surgeons in Ireland
 
5
Matshediso Mokoka
Royal College of Surgeons in Ireland
Total Publications: 7
 
6
Breda Cushen
Royal College of Surgeons in Ireland
Total Publications: 13
 
7
Shona D'Arcy
Royal College of Surgeons in Ireland
Total Publications: 12
 
8
Viliam Rapcan
Trinity College Dublin
Total Publications: 10
 
9
Susan M O'Dwyer
Royal College of Surgeons in Ireland
Total Publications: 4
 
10
Fiona Boland
Royal College of Surgeons in Ireland
Total Publications: 44