Asthma Inhaler Medications – Controller inhalers are highly effective in reducing the weight and risk of asthma, but many patients do not use them frequently. This bad adherence contributes to uncontrolled symptoms, diminished quality of life, flare-ups, desperate doctor visits and lack of life. General practitioners (GPs) identify bad adherence with controller inhalers as a significant barrier to the delivery of effective asthma care, yet practical adherence interventions are lacking.
In a study recently released in The Journal of Allergy and Clinical Immunology (JACI), Foster and colleagues conducted a 6-month cluster randomized controlled trial that tested the potency of 2 GP-delivered interventions designed to tackle poor medication-taking patterns and/or patients’ concerns regarding inhaler usage. The participants were divided into four classes. One group received automated twice-daily inhaler reminders for missed doses plus adherence feedback via a tracking device clipped to the inhaler, and a secure website accessible by individuals and their GP; the reminders may be customized or ceased by patients. Another group engaged in personalized adherence talks with their doctors about crucial obstacles to medication-taking; a third group received both interventions. A fourth group received active usual care alone; all GPs received short action program and inhaler technique training. For many patients, electronic inhaler monitors remotely uploaded adherence data for analysis.
In this first ever research in primary care, patients receiving admissions took on average 73 percent of the prescribed daily doses over 6 months compared to just 46 percent in patients who didn’t have reminders. Further, though there was no difference in symptom management between classes, severe flare-ups were experienced significantly less by individuals receiving reminders than those not receiving them (11% versus 28 percent). There were no differences between groups receiving or not receiving personalized adherence talks. Half of participating patients and GPs lived or practiced in a socially disadvantaged site.
The authors’ findings demonstrate that reminders and feedback for control inhaler use significantly improve treatment adherence for at least six weeks, and are considered acceptable and achievable by asthma patients and GPs in real-world main care settings.