Adherence with controller medication in adults with asthma–impact of hospital admission for acute exacerbation
Research output: Contribution to journal › Journal article › Research › peer-review
Standard
Adherence with controller medication in adults with asthma–impact of hospital admission for acute exacerbation. / Staehr Holm, Freja; Håkansson, Kjell Erik Julius; Ulrik, Charlotte Suppli.
In: Journal of Asthma, Vol. 59, No. 9, 2022, p. 1899-1907.Research output: Contribution to journal › Journal article › Research › peer-review
Harvard
APA
Vancouver
Author
Bibtex
}
RIS
TY - JOUR
T1 - Adherence with controller medication in adults with asthma–impact of hospital admission for acute exacerbation
AU - Staehr Holm, Freja
AU - Håkansson, Kjell Erik Julius
AU - Ulrik, Charlotte Suppli
N1 - Publisher Copyright: © 2021 Taylor & Francis Group, LLC.
PY - 2022
Y1 - 2022
N2 - Objective: Uncontrolled asthma is associated with higher risk of hospital admissions and death. Low adherence to inhaled corticosteroid (ICS), the cornerstone of asthma therapy, is well-documented. Our aim was to investigate if hospital admission with an acute exacerbation of asthma changes ICS adherence. Methods: This retrospective cohort study comprises 241 patients hospitalized with an asthma exacerbation over 12 months (May 2019–April 2020). The primary outcome was proportion of ICS adherent patients, defined as Medication Possession Ratio (MPR) ≥80%, in the six-month period before and after admission. Results: The pre- to post-admission proportion of ICS adherent patients increased from 10% to 13% (p = 0.25) and the mean ICS MPR increased from 34% to 42% (p < 0.001). Different patterns of post-discharge adherence were observed, as adherent patients remained adherent, while patients with poor pre-admission adherence increased their adherence during two months after discharge followed by a decline in MPR. Co-variates such as sex, age, body mass index (BMI), GINA 2020-treatment step did not predict improvement in adherence after discharge. Conclusions: Admission with an asthma exacerbation did not increase the proportion of patients adherent with controller medication, primarily ICS. Although an improvement in adherence was initially seen primarily in previously poorly adherent patients, this increase was transient as it decreased over time post-discharge.
AB - Objective: Uncontrolled asthma is associated with higher risk of hospital admissions and death. Low adherence to inhaled corticosteroid (ICS), the cornerstone of asthma therapy, is well-documented. Our aim was to investigate if hospital admission with an acute exacerbation of asthma changes ICS adherence. Methods: This retrospective cohort study comprises 241 patients hospitalized with an asthma exacerbation over 12 months (May 2019–April 2020). The primary outcome was proportion of ICS adherent patients, defined as Medication Possession Ratio (MPR) ≥80%, in the six-month period before and after admission. Results: The pre- to post-admission proportion of ICS adherent patients increased from 10% to 13% (p = 0.25) and the mean ICS MPR increased from 34% to 42% (p < 0.001). Different patterns of post-discharge adherence were observed, as adherent patients remained adherent, while patients with poor pre-admission adherence increased their adherence during two months after discharge followed by a decline in MPR. Co-variates such as sex, age, body mass index (BMI), GINA 2020-treatment step did not predict improvement in adherence after discharge. Conclusions: Admission with an asthma exacerbation did not increase the proportion of patients adherent with controller medication, primarily ICS. Although an improvement in adherence was initially seen primarily in previously poorly adherent patients, this increase was transient as it decreased over time post-discharge.
KW - compliance
KW - hospitalization
KW - Inhaled corticosteroids
KW - medication possession ratio
KW - severe exacerbation of asthma
U2 - 10.1080/02770903.2021.1971702
DO - 10.1080/02770903.2021.1971702
M3 - Journal article
C2 - 34425724
AN - SCOPUS:85114405749
VL - 59
SP - 1899
EP - 1907
JO - Journal of Asthma
JF - Journal of Asthma
SN - 0277-0903
IS - 9
ER -
ID: 279821641