The relationship between clinical outcomes and medication adherence in difficult-to-control asthma
- Anna C Murphy1,2,
- Amandine Proeschal3,
- Christopher E Brightling1,2,4,
- Andrew J Wardlaw1,2,4,
- Ian Pavord1,2,4,
- Peter Bradding1,2,4,
- Ruth H Green1,2,4
- 1Institute for Lung Health, Leicester, UK
- 2University Hospitals of Leicester NHS Trust, Leicester, UK
- 3School of Pharmacy, Grenoble, France
- 4Department of Infection, Immunity and Inflammation, University of Leicester, Leicester, UK
- Correspondence to Anna C Murphy, Consultant Respiratory Pharmacist, Department of Respiratory Medicine, Glenfield Hospital, Leicester LE3 9QP, UK;
- Received 12 September 2011
- Accepted 29 February 2012
- Published Online First 21 March 2012
Medication non-adherence and the clinical implications in difficult-to-control asthma were audited. Prescription issue data from 115 patients identified sub-optimal adherence (<80%) in 65% of patients on inhaled corticosteroids (ICS) or combined ICS/long-acting β2 agonist (LABA). In those using separate ICS and LABA, adherence to LABA (50%) was significantly better than to ICS (14.3%). Patients with sub-optimal ICS adherence had reduced FEV1 and higher sputum eosinophil counts. Adherence ratio was an independent predictor of previous ventilation for acute severe asthma (p=0.008). The majority of patients with difficult-to-control asthma are non-adherent with their asthma medication. Non-adherence is correlated with poor clinical outcomes.
- anti-asthmatic drugs
- allergic lung disease
- asthma pharmacology
- COPD mechanisms
- asthma mechanisms
- COPD exacerbations
- airway epithelium
- cytokine biology
- eosinophil biology
- innate immunity
- asthma guidelines
- clinical epidemiology
- exhaled airway markers
PB and RHG authors are Co-senior authors.
Competing interests None.
Provenance and peer review Not commissioned; externally peer reviewed.