Measurement of inhaled corticosteroid adherence in inner-city, minority children with persistent asthma by parental report and integrated dose counter

Marina Reznik, Philip O Ozuah, Marina Reznik, Philip O Ozuah

Abstract

Parents often overreport adherence to asthma treatment regimens making accurate assessment of medication adherence in clinical practice difficult. This study was conducted to compare two adherence assessment methods clinicians may choose from when assessing patient inhaled corticosteroid (ICS) adherence: parental report and dose counter measurements of metered-dose inhaler (MDI) actuation. Participants included children (N = 50) with persistent asthma and their parents (N = 50). At enrollment, children received a new, marked ICS at the dose prescribed by their physician. Thirty days following enrollment, we measured ICS adherence by parental report and objectively, with a dose counter. Parental report overestimated ICS adherence when compared to dose counter. We found a statistically significant overall difference between parental report and objectively measured adherence. A dose counter that most ICS inhalers are equipped with may be a more reliable alternative measure of ICS adherence in a clinical practice setting.

Figures

Figure 1
Figure 1
Comparison of two methods of assessment of ICS adherence.
Figure 2
Figure 2
Comparison of two methods of assessment of ICS nonadherence.

References

    1. Claudio L, Stingone JA, Godbold J. Prevalence of childhood asthma in urban communities: the impact of ethnicity and income. Annals of Epidemiology. 2006;16(5):332–340.
    1. Garg R, Carpati A, Leighton J, Perrin M, Shah M. Asthma Facts. 2nd edition. New York, NY, USA: New York City Department of Health and Mental Hygiene; 2003. .
    1. Cloutier MM, Hall CB, Wakefield DB, Bailit H. Use of asthma guidelines by primary care providers to reduce hospitalizations and emergency department visits in poor, minority, urban children. Journal of Pediatrics. 2005;146(5):591–597.
    1. Bender BG, Annett RD, Iklé D, DuHamel TR, Rand C, Strunk RC. Relationship between disease and psychological adaptation in children in the childhood asthma management program and their families. Archives of Pediatrics and Adolescent Medicine. 2000;154(7):706–713.
    1. Celano M, Geller RJ, Phillips KM, Ziman R. Treatment adherence among low-income children with asthma. Journal of Pediatric Psychology. 1998;23(6):345–349.
    1. Carter ER, Ananthakrishnan M. Adherence to montelukast versus inhaled corticosteroids in children with asthma. Pediatric Pulmonology. 2003;36(4):301–304.
    1. Bender B, Milgrom H, Apter A. Adherence intervention research: what have we learned and what do we do next? Journal of Allergy and Clinical Immunology. 2003;112(3):489–494.
    1. Rau JL. Determinants of patient adherence to an aerosol regimen. Respiratory Care. 2005;50(10):1346–1356. discussion 1349–1357.
    1. Bender B, Wamboldt F, O’Connor SL, et al. Measurement of children’s asthma medication adherence by self report, mother report, canister weight, and Doser CT. Annals of Allergy, Asthma and Immunology. 2000;85(5):416–421.
    1. Jentzsch NS, Camargos PAM. Methods of assessing adherence to inhaled corticosteroid therapy in children and adolescents: adherence rates and their implications for clinical practice. Jornal Brasileiro de Pneumologia. 2008;34(8):614–621.
    1. Wamboldt FS, Bender BG, O’Connor SL, et al. Reliability of the model MC-311 MDI Chronolog. Journal of Allergy and Clinical Immunology. 1999;104(1):53–57.
    1. Bender B, Milgrom H, Rand C, Ackerson L. Psychological factors associated with medication nonadherence in asthmatic children. Journal of Asthma. 1998;35(4):347–353.
    1. Weinstein AG. Should patients with persistent severe asthma be monitored for medication adherence? Annals of Allergy, Asthma and Immunology. 2005;94(2):251–257.
    1. National Heart, Lung, and Blood Institute. National Asthma Education and Prevention Program Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma. U.S. Department if Health and Human Services. Full Report 2007, NIH Publication 08-4051, 2011, .
    1. Sheth K, Wasserman RL, Lincourt WR, Locantore NW, Carranza-Rosenzweig J, Crim C. Fluticasone propionate/salmeterol hydrofluoroalkane via metered-dose inhaler with integrated dose counter: performance and patient satisfaction. International Journal of Clinical Practice. 2006;60(10):1218–1224.
    1. Shah S, White M, Uryniak T, O’Brien CD. The functionality of a budesonide/formoterol pressurized metered-dose inhaler with an integrated actuation counter. Allergy and Asthma Proceedings. 2010;31(1):40–48.
    1. Weinstein C, Staudinger H, Scott I, Amar NJ, LaForce C. Dose counter performance of mometasone furoate/formoterol inhalers in subjects with asthma or COPD. Respiratory Medicine. 2011;105:979–988.
    1. Laforce C, Weinstein C, Nathan RA, Weinstein SF, Staudinger H, Meltzer EO. Patient satisfaction with a pressurized metered-dose inhaler with an integrated dose counter containing a fixed-dose mometasone furoate/formoterol combination. Journal of Asthma. 2011;48(6):625–631.
    1. United States Census Bureau. US Census 2010. 2011. .
    1. Modi AC, Guilfoyle SM, Morita DA, Glauser TA. Development and reliability of a correction factor for parent-reported adherence to pediatric antiepileptic drug therapy. Epilepsia. 2011;52:370–376.
    1. Milgrom H, Bender B, Ackerson L, Bowry P, Smith B, Rand C. Noncompliance and treatment failure in children with asthma. Journal of Allergy and Clinical Immunology. 1996;98(6):1051–1057.
    1. Julius SM, Sherman JM, Hendeles L. Accuracy of three electronic monitors for metered-dose inhalers. Chest. 2002;121(3):871–876.
    1. Brueckner JW, Marshik P, Sherman J, Hendeles L. Reliability of the Medtrac MDI chronolog. Journal of Allergy and Clinical Immunology. 1997;100(4):488–491.
    1. Simmons MS, Nides MA, Kleerup EC, et al. Validation of the Doser, a new device for monitoring metered-dose inhaler use. Journal of Allergy and Clinical Immunology. 1998;102(3):409–413.

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