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Link identified between difficult asthma and non adherence

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Researchers from Northern Ireland have found that a significant proportion of patients with difficult-to-control asthma do not adhere to prescribed corticosteroid therapy.

Researcher studied 182 patients with difficult-to-control asthma to identify whether they requested repeat prescriptions for inhaled combination therapy and short-acting beta-agonists. Blood plasma prednisolone and cortisol assay levels were used to assess adherence to oral prednisolone. Factors including hospital admissions, lung function, oral prednisolone courses, and quality of life data were analyzed to indentify variables associated with reduced medication adherence.

Sixty-three patients (35%) filled 50% or fewer inhaled medication prescriptions; 88% admitted poor adherence with inhaled therapy after initially denying this. Twenty-one percent of patients filled more than 100% of presciptions, and 45% of subjects filled between 51 and 100% of prescriptions. 45% of patients who were prescribed oral steroids did not take their medicines as prescribed.

The authors recommend that adherence to medicines should be assessed before more expensive and aggressive treatments are considered for patients with difficult to treat asthma.

American Journal of Respiratory and Critical Care Medicine (2009); 180: 817-822

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Readers' comments (2)

  • Hi, am a 46 yrs old nurse working at the community.
    I have asthma and recently become very severe just been told have COPD. I have never smoked, my family were nonsmokers as I grew up. Have allergy problem of an known cause which now has become very severe and have to go to A & E at least twice a month not to mention Asthma attacks which also making me frequent the emergency department. Just want to know how the two are related as every time I have allergy reaction end up going down with Asthma. I am over weight due to low thyroid problem and continous intake of steroid. Please any advice.

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  • you mean it took money and researchers to find out what the majority of us nurses knew that poor/difficult to control asthma was mainly due to lack of medication adherence/ poor compliance or that some pt's with difficult to control asthma was still smoking 50 cigarettes a day.

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