Inhaler reminders improve adherence with controller treatment in primary care patients with asthma Juliet M. Foster, PhD, Tim Usherwood, BSc, MD, BS,

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Presentation transcript:

Inhaler reminders improve adherence with controller treatment in primary care patients with asthma Juliet M. Foster, PhD, Tim Usherwood, BSc, MD, BS, Lorraine Smith, PhD, Susan M. Sawyer, MBBS, MD, Wei Xuan, MSc, MAppStat, PhD, Cynthia S. Rand, PhD, Helen K. Reddel, MBBS, PhD Journal of Allergy and Clinical Immunology Volume 134, Issue 6, Pages 1260-1268.e3 (December 2014) DOI: 10.1016/j.jaci.2014.05.041 Copyright © 2014 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 1 A, SmartTrack device installed on a fluticasone propionate/salmeterol inhaler. B, Example adherence feedback for IRF groups. The device electronically recorded the date/time of every actuation. The screen display (time since last dose taken) was seen only by patients in IRF groups. Feedback could be viewed by the IRF patient and his or her GP on a secure Web site. The graph showed the number of inhalations prescribed (dotted line) and the number of inhalations the patient took each day over a 14-day period. Patients and their GPs could access this graph on a password-protected Web site and a copy was e-mailed to them every 30 days. Journal of Allergy and Clinical Immunology 2014 134, 1260-1268.e3DOI: (10.1016/j.jaci.2014.05.041) Copyright © 2014 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 2 Flow of GPs and participants (intention-to-treat [ITT] population) through the study. The number of GPs in each intervention group who did not enroll a patient: UC = 0, PAD = 1, IRF = 1, IRF + PAD = 1. *GPs withdrew before allocation revealed and study training received. †Number of patients excluded from ITT analysis (asthma control) because of dropout or lost to follow-up before the completion of 2 or more study questionnaires. Journal of Allergy and Clinical Immunology 2014 134, 1260-1268.e3DOI: (10.1016/j.jaci.2014.05.041) Copyright © 2014 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 3 A, Mean asthma control (ACT score, primary outcome) by time point. B, Average ICS/LABA adherence over 6 months by intervention group. C, Mean ICS/LABA adherence by group and study month. D, Mean asthma quality of life (Mini AQLQ) by time point. Mini AQLQ, Mini Asthma Quality of Life Questionnaire. All GPs in all groups including UC received training in inhaler technique checking and writing an asthma action plan. All error bars 95% CIs. A change of 3 or more points in the ACT score represents a clinically important change; a score of more than 19 points represents good asthma control. Adherence monitors were activated at T0 (10.4 ± 7.3 days after patient enrolled and intervention delivered; no baseline adherence data available). A change of 0.5 or more in Mini AQLQ score represents a clinically important change. *P < .0001. Journal of Allergy and Clinical Immunology 2014 134, 1260-1268.e3DOI: (10.1016/j.jaci.2014.05.041) Copyright © 2014 American Academy of Allergy, Asthma & Immunology Terms and Conditions