TY - JOUR
T1 - Metered dose inhaler technique among inner-city asthmatics and its association with asthma medication adherence
AU - Lurslurchachai, Linda
AU - Krauskopf, Katherine
AU - Roy, Angkana
AU - Halm, Ethan A.
AU - Leventhal, Howard
AU - Wisnivesky, Juan P.
N1 - Publisher Copyright:
© 2013 John Wiley & Sons Ltd.
PY - 2014/10/1
Y1 - 2014/10/1
N2 - Introduction: Inhaled medications, critical for asthma treatment, are self-administered through metered dose inhalers (MDI). Asthma self-management hinges on adherence to these medications and to proper MDI technique. Objective: To assess predictors of proper MDI technique, and MDI technique as a tool to identify patients with low adherence to inhaled medications. Methods: Prospective cohort of asthmatics from clinics in New York, NY and New Brunswick, NJ. MDI technique was assessed using a standardized checklist. Adherence to inhaled asthma controller medication was evaluated with the Medication Adherence Report Scale. Predictors of MDI technique were evaluated using regression analyses. The distribution of number of MDI technique steps missed was compared in adherent vs. non-adherent asthmatics. Results: Overall, 326 patients were included (55% Hispanic, 27% Black). In adjusted analyses, age<55 years was significantly associated with MDI technique (P=0.03). Overall, 12%, 34%, 40% of asthmatics missed 5-6, 3-4, or 1-2 MDI steps; 16% received a perfect MDI technique score. Adherence rates were 20%, 39%, 48%, and 62% among those who missed 5-6, 3-4, 1-2, or none of the steps in the MDI technique checklist (P<0.001). Conclusion: Poor MDI technique is common among inner-city patients with asthma and is associated with poor adherence to controller medications. Older patients with asthma are at higher risk of improper MDI technique. Assessment of MDI technique may be a simple clinical aid to identify patients with low adherence to controller medications.
AB - Introduction: Inhaled medications, critical for asthma treatment, are self-administered through metered dose inhalers (MDI). Asthma self-management hinges on adherence to these medications and to proper MDI technique. Objective: To assess predictors of proper MDI technique, and MDI technique as a tool to identify patients with low adherence to inhaled medications. Methods: Prospective cohort of asthmatics from clinics in New York, NY and New Brunswick, NJ. MDI technique was assessed using a standardized checklist. Adherence to inhaled asthma controller medication was evaluated with the Medication Adherence Report Scale. Predictors of MDI technique were evaluated using regression analyses. The distribution of number of MDI technique steps missed was compared in adherent vs. non-adherent asthmatics. Results: Overall, 326 patients were included (55% Hispanic, 27% Black). In adjusted analyses, age<55 years was significantly associated with MDI technique (P=0.03). Overall, 12%, 34%, 40% of asthmatics missed 5-6, 3-4, or 1-2 MDI steps; 16% received a perfect MDI technique score. Adherence rates were 20%, 39%, 48%, and 62% among those who missed 5-6, 3-4, 1-2, or none of the steps in the MDI technique checklist (P<0.001). Conclusion: Poor MDI technique is common among inner-city patients with asthma and is associated with poor adherence to controller medications. Older patients with asthma are at higher risk of improper MDI technique. Assessment of MDI technique may be a simple clinical aid to identify patients with low adherence to controller medications.
KW - Asthma
KW - Controller medications
KW - Elderly asthmatics
KW - Metered dose inhaler technique
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U2 - 10.1111/crj.12084
DO - 10.1111/crj.12084
M3 - Article
C2 - 24308876
AN - SCOPUS:84908364544
SN - 1752-6981
VL - 8
SP - 397
EP - 403
JO - Clinical Respiratory Journal
JF - Clinical Respiratory Journal
IS - 4
ER -