Medication Adherence in Patients With Severe Asthma Prescribed Oral Corticosteroids in the U-BIOPRED Cohort.

Alahmadi, Fahad H; Simpson, Andrew J; Gomez, Cristina; Ericsson, Magnus; Thörngren, John-Olof; Wheelock, Craig; Shaw, Dominic E; Fleming, Louise J; Roberts, Graham; Riley, John; Bates, Stewart; Sousa, Ana R; Knowles, Richard; Bansal, Aruna T; Corfield, Julie; Pandis, Ioannis; Sun, Kai; Bakke, Per S; Caruso, Massimo; Chanez, Pascal; ... (2021). Medication Adherence in Patients With Severe Asthma Prescribed Oral Corticosteroids in the U-BIOPRED Cohort. Chest, 160(1), pp. 53-64. Elsevier 10.1016/j.chest.2021.02.023

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BACKGROUND

Although estimates of suboptimal adherence to oral corticosteroids in asthma range from 30% to 50%, no ideal method for measurement exists; the impact of poor adherence in severe asthma is likely to be particularly high.

RESEARCH QUESTIONS

What is the prevalence of suboptimal adherence detected by self-reporting and direct measures? Is suboptimal adherence associated with disease activity?

STUDY DESIGN AND METHODS

Data were included from individuals with severe asthma taking part in the U-BIOPRED (Unbiased Biomarkers for the Prediction of Respiratory Disease Outcomes) study and prescribed daily oral corticosteroids. Participants completed the Medication Adherence Report Scale, a five-item questionnaire used to grade adherence on a scale from 1 to 5, and provided a urine sample for analysis of prednisolone and metabolites by liquid chromatography-mass spectrometry.

RESULTS

Data from 166 participants were included in this study: mean (SD) age, 54.2 (± 11.9) years; FEV1, 65.1% (± 20.5%) predicted; female, 58%; 37% completing the Medication Adherence Report Scale reported suboptimal adherence; and 43% with urinary corticosteroid data did not have detectable prednisolone or metabolites in their urine. Good adherence by both methods was detected in the 35% of participants in whom both methods were performed; adherence detection did not match between methods in 53%. Self-reported high adherers had better asthma control and quality of life, whereas directly measured high adherers had lower blood eosinophil levels.

INTERPRETATION

Low adherence is a common problem in severe asthma, whether measured directly or self-reported. We report poor agreement between the two methods, suggesting some disassociation between self-assessment of medication adherence and regular oral corticosteroid use, which suggests that each approach may provide complementary information in clinical practice.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Paediatric Medicine
04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > Unit Childrens Hospital > Forschungsgruppe Pneumologie (Pädiatrie)
04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > Unit Childrens Hospital
04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Paediatric Medicine > Paediatric Pneumology

UniBE Contributor:

Singer, Florian

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1931-3543

Publisher:

Elsevier

Language:

English

Submitter:

Anette van Dorland

Date Deposited:

15 Jun 2021 15:34

Last Modified:

20 Jul 2022 10:01

Publisher DOI:

10.1016/j.chest.2021.02.023

PubMed ID:

33610577

Uncontrolled Keywords:

adherence asthma urinary corticosteroids

BORIS DOI:

10.48350/156593

URI:

https://boris.unibe.ch/id/eprint/156593

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