Asthma and lower airway diseaseA cluster-randomized trial to provide clinicians inhaled corticosteroid adherence information for their patients with asthma
Section snippets
Study participants
The primary purpose of this trial was to determine whether providing individual patient medication adherence information to physicians electronically for discussion with their patients with asthma could result in improved inhaled corticosteroid use. This study was approved by the Henry Ford Health System institutional review board and was in compliance with its Health Insurance Portability and Accountability Act policy. The study was implemented in a single, large, integrated health system
Results
We enrolled 193 (93.2%) of 207 primary care providers from 34 practice groups throughout the health system (Fig 1). This group of providers included 49 family medicine practitioners, 88 internists, 5 internists/pediatricians, 41 pediatricians, 9 physician assistants, and 1 nurse practitioner. One pediatrician from the intervention group withdrew after enrollment. Seventeen practices (88 providers) were randomly assigned to the intervention arm, and 17 practices (105 providers) were assigned
Discussion
To our knowledge, this is the first large-scale, controlled study to test the effectiveness of routinely providing patient medication adherence information to clinicians. Although smaller studies have suggested that medication use improves when clinicians are provided measures of adherence to discuss with their patients,10, 20, 21, 22, 23 the processing and delivery of these data to health care providers in these earlier interventions were more labor-intensive, thus limiting their applicability
References (32)
- et al.
Relationship between adherence to inhaled corticosteroids and poor outcomes among adults with asthma
J Allergy Clin Immunol
(2004) - et al.
Modifiable barriers to adherence to inhaled steroids among adults with asthma: it's not just black and white
J Allergy Clin Immunol
(2003) - et al.
Noncompliance and treatment failure in children with asthma
J Allergy Clin Immunol
(1996) - et al.
Adherence intervention research: what have we learned and what do we do next?
J Allergy Clin Immunol
(2003) - et al.
Direct clinician-to-patient feedback discussion of inhaled steroid use: its effect on adherence
Ann Allergy Asthma Immunol
(2003) - et al.
Patients with asthma who do not fill their inhaled corticosteroids: a study of primary nonadherence
J Allergy Clin Immunol
(2007) - et al.
The assessment of refill compliance using pharmacy records: methods, validity, and applications
J Clin Epidemiol
(1997) - et al.
Relationship between recent short-acting beta-agonist use and subsequent asthma exacerbations
Ann Allergy Asthma Immunol
(2008) - et al.
Can prescription refill feedback to physicians improve patient adherence?
Am J Med Sci
(2004) - et al.
Electronic monitoring and counseling to improve medication adherence
Behav Res Ther
(2004)
Medication nonadherence is associated with a broad range of adverse outcomes in patients with coronary artery disease
Am Heart J
Race-ethnicity, crime, and other factors associated with adherence to inhaled corticosteroids
J Allergy Clin Immunol
Dispensing of fluticasone propionate/salmeterol combination in the summer and asthma-related outcomes in the fall
J Allergy Clin Immunol
Adherence to medication
N Engl J Med
The beliefs about medicines questionnaire: the development and evaluation of a new method for assessing the cognitive representation of medication
Psychol Health
Expert Panel Report 3 (EPR-3): guidelines for the diagnosis and management of asthma-summary report 2007
J Allergy Clin Immunol
Cited by (66)
Dyslipidemia Is Associated With Worse Asthma Clinical Outcomes: A Prospective Cohort Study
2023, Journal of Allergy and Clinical Immunology: In PracticeAdherence to adding inhaled corticosteroids to rescue therapy in a pragmatic trial with adults with asthma: A pilot study
2020, Annals of Allergy, Asthma and ImmunologySafety, pharmacokinetics and pharmacodynamics of a novel anti-asthmatic drug, XC8, in healthy probands
2019, Pulmonary Pharmacology and TherapeuticsNew drugs for severe asthma
2016, Presse Medicale
Supported by grants from the National Heart, Lung, and Blood Institute (HL79055), the National Institute of Allergy and Infectious Diseases (AI61774, AI79139), the National Institute of Diabetes and Digestive and Kidney Diseases (DK64695), National Institutes of Health; the Fund for Henry Ford Hospital; and the Strategic Program for Asthma Research of the American Asthma Foundation.
Disclosure of potential conflict of interest: L. K. Williams has received research support from the National Institutes of Health and has served on an advisory board for Merck. E. L. Peterson has received research support from the National Institutes of Health. D. E. Lanfear has received research support from Merck and the National Institutes of Health (NHLBI). The rest of the authors have declared that they have no conflict of interest.
Trial registration: clinicaltrials.gov identifier: NCT00459368.