Chest
ReviewsInhaled Corticosteroids for Asthma Therapy: Patient Compliance, Devices, and Inhalation Technique
Section snippets
Materials and Methods
The literature review started with a thorough key word search of the National Library of Medicine's MEDLINE database for articles on inhaled asthma therapy published between January 1966 and 1997. We examined the abstracts of these articles and identified articles that presented the results of studies of compliance, inhalation technique, and lung deposition of inhaled asthma drugs. We obtained these articles and examined their references for any other articles pertaining to these issues. We
Compliance
Table 1 shows the results of studies that used an electronic measuring device to estimate compliance with ICSs in asthma patients. Overall, patients took the recommended doses of medication on 20 to 73% of days. The percentage of underuse days ranged from 24 to 69%. Overuse (2 to 23%) is much less frequent than underuse. Average compliance, measured as the ratio of the doses taken to those prescribed, ranged from 63 to 92%. The 92% compliance was observed in a study by van der Palen et al16 and
Discussion
In this paper, we examined three factors influencing the effectiveness of asthma treatment with ICSs in practice—patient compliance, inhalation technique, and lung aerosol deposition. We found that only a small percentage of the prescribed dose of an ICS is likely to reach the target organ, the lung, because of patient noncompliance with the prescribed dose, difficulty in correct use of the inhaler, and the ability of a properly used inhaler to deliver the drug to the lung.
As with any chronic
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Discussant section
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Cited by (0)
Research support was provided by Merck & Co. to Dr. Bala, Ms. Downs, and Dr. Mauskopf. Dr. Ben-Joseph is an employee of Merck & Co. Dr. Bala was employed at Research Triangle Institute when the article was written.