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). CONCLUSION: 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.
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Submitted on : Friday, July 13, 2018 - 4:45:27 PM
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L. Laforest, É van Ganse, G. Devouassoux, G. Chatté, C. Tamberou, et al.. Deliberate interruptions and changes of dose of inhaled corticosteroids by asthma patients: "a community pharmacy study". Revue des Maladies Respiratoires, Elsevier Masson, 2015, 32 (1), pp.8--17. ⟨10.1016/j.rmr.2014.04.103⟩. ⟨hal-01838976⟩

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