Open adherence monitoring using routine data download from an adaptive aerosol delivery nebuliser in children with cystic fibrosis Paul S. McNamara,

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Open adherence monitoring using routine data download from an adaptive aerosol delivery nebuliser in children with cystic fibrosis Paul S. McNamara, Pamela McCormack, Alison J. McDonald, Louisa Heaf, Kevin W. Southern Journal of Cystic Fibrosis Volume 8, Issue 4, Pages 258-263 (July 2009) DOI: 10.1016/j.jcf.2009.04.006 Copyright © 2009 European Cystic Fibrosis Society Terms and Conditions

Fig. 1 Mean (SEM) time for medication to be taken through the I-neb over the twelve months following start of treatment. Mean [SD] treatment time increased over the year from 3.8[2.1] minutes (median [range], 3[2–11] minutes) during the first month of treatment to 5.9[4.2] minutes (4[1–20] minutes) during the twelfth month (p=0.002). Journal of Cystic Fibrosis 2009 8, 258-263DOI: (10.1016/j.jcf.2009.04.006) Copyright © 2009 European Cystic Fibrosis Society Terms and Conditions

Fig. 2 Morning and evening adherence in children (n=28) for the six months following start of treatment. Evening adherence was significantly higher than that in the morning (p=0.012). The obvious outlier is a teenager who, on schooldays, took both his daily treatments immediately after school and towards midnight, rather than in the morning. Journal of Cystic Fibrosis 2009 8, 258-263DOI: (10.1016/j.jcf.2009.04.006) Copyright © 2009 European Cystic Fibrosis Society Terms and Conditions

Fig. 3 Mean (SEM) overall adherence for the year following start of treatment. All patients were prescribed twice daily colistin for the first six months of treatment. During the second six months of the year, eight patients were changed to once daily double-dose colistin based on their adherence data. Journal of Cystic Fibrosis 2009 8, 258-263DOI: (10.1016/j.jcf.2009.04.006) Copyright © 2009 European Cystic Fibrosis Society Terms and Conditions

Fig. 4 Monthly overall adherence for individual patients over the first year of treatment. Considerable variation is seen both between and within patients. Journal of Cystic Fibrosis 2009 8, 258-263DOI: (10.1016/j.jcf.2009.04.006) Copyright © 2009 European Cystic Fibrosis Society Terms and Conditions

Fig. 5 Adherence to treatment in the three months before and after a change in treatment regime from twice daily to once daily double-dose colistin. A transient improvement in adherence is demonstrated in most patients. Journal of Cystic Fibrosis 2009 8, 258-263DOI: (10.1016/j.jcf.2009.04.006) Copyright © 2009 European Cystic Fibrosis Society Terms and Conditions