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Audit update
The relationship between clinical outcomes and medication adherence in difficult-to-control asthma
  1. Anna C Murphy1,2,
  2. Amandine Proeschal3,
  3. Christopher E Brightling1,2,4,
  4. Andrew J Wardlaw1,2,4,
  5. Ian Pavord1,2,4,
  6. Peter Bradding1,2,4,
  7. Ruth H Green1,2,4
  1. 1Institute for Lung Health, Leicester, UK
  2. 2University Hospitals of Leicester NHS Trust, Leicester, UK
  3. 3School of Pharmacy, Grenoble, France
  4. 4Department of Infection, Immunity and Inflammation, University of Leicester, Leicester, UK
  1. Correspondence to Anna C Murphy, Consultant Respiratory Pharmacist, Department of Respiratory Medicine, Glenfield Hospital, Leicester LE3 9QP, UK; anna.murphy{at}


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.

  • Asthma
  • anti-asthmatic drugs
  • adherence
  • medication
  • compliance
  • allergic lung disease
  • asthma pharmacology
  • COPD mechanisms
  • asthma mechanisms
  • COPD exacerbations
  • cough/mechanisms/pharmacology
  • airway epithelium
  • cytokine biology
  • eosinophil biology
  • innate immunity
  • asthma guidelines
  • clinical epidemiology
  • exhaled airway markers

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  • PB and RHG authors are Co-senior authors.

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.