Patient-physician discordance in assessment of adherence to inhaled controller medication: a cross-sectional analysis of two cohorts
Cristina Jácome,Ana Margarida Pereira,Rute Almeida,Manuel Ferreira-Magalhães,Mariana Couto,Luis Araujo,Mariana Pereira,M Correia,Cláudia Chaves Loureiro,Maria Joana Catarata,Lilia Maia Santos,João Pereira,Bárbara Ramos,Cristina Lopes,Ana Mendes,José Carlos Cidrais Rodrigues,Georgeta Oliveira,Ana Paula Aguiar,Ivete Afonso,Joana Carvalho,Ana Arrobas,José Coutinho Costa,Joana Dias,Ana Todo Bom,João Lúcio de Azevedo,Carmelita Ribeiro,Marta Alves,Paula Leiria Pinto,Nuno Neuparth,Ana Palhinha,J Marques,Nicole Pinto,Pedro Martins,Filipa Todo Bom,Maria Alvarenga Santos,Alberto Costa,Armandina Moreira da Silva Neto,Marta Santalha,Carlos Lozoya,Natacha Santos,Diana Silva,Maria João Vasconcelos,Luís Taborda-Barata,Célia Carvalhal,Maria Fernanda Teixeira,Rodrigo Rodrigues Alves,Ana Sofia Moreira,Cláudia Pinto,Pedro Morais Silva,C. Alves,Raquel Câmara,Didina Coelho,Diana Bordalo,Ricardo M. Fernandes,Rosário Ferreira,Fernando Menezes,Ricardo Gomes,Maria José Cálix,Ana Patrícia Marques,João Cardoso,Madalena Emiliano,Rita Gerardo,Carlos Nunes,Rita Câmara,José Alberto Ferreira,Aurora Carvalho,Paulo P. Freitas,Ricardo Correia,João Fonseca +68 more
Reads0
Chats0
TLDR
Although both patients and physicians report high inhaler adherence, discordance occurred in half of cases, implementation of objective adherence measures and effective communication are needed to improve patient-physician agreement.Abstract:
Objective We aimed to compare patient’s and physician’s ratings of inhaled medication adherence and to identify predictors of patient-physician discordance. Design Baseline data from two prospective multicentre observational studies. Setting 29 allergy, pulmonology and paediatric secondary care outpatient clinics in Portugal. Participants 395 patients (≥13 years old) with persistent asthma. Measures Data on demographics, patient-physician relationship, upper airway control, asthma control, asthma treatment, forced expiratory volume in one second (FEV1) and healthcare use were collected. Patients and physicians independently assessed adherence to inhaled controller medication during the previous week using a 100 mm Visual Analogue Scale (VAS). Discordance was defined as classification in distinct VAS categories (low 0–50; medium 51–80; high 81–100) or as an absolute difference in VAS scores ≥10 mm. Correlation between patients’ and physicians’ VAS scores/categories was explored. A multinomial logistic regression identified the predictors of physician overestimation and underestimation. Results High inhaler adherence was reported both by patients (median (percentile 25 to percentile 75) 85 (65–95) mm; 53% VAS>80) and by physicians (84 (68–95) mm; 53% VAS>80). Correlation between patient and physician VAS scores was moderate (rs=0.580; p Conclusion Although both patients and physicians report high inhaler adherence, discordance occurred in half of cases. Implementation of objective adherence measures and effective communication are needed to improve patient-physician agreement.read more
Citations
More filters
Journal ArticleDOI
Pathophysiological Mechanisms of Asthma.
TL;DR: Management of the asthmas can and should be improved by considering the pathophysiologies of the different airway diseases lumped under that umbrella term, using simple, non-invasive tests which are readily available, and treating accordingly.
Journal ArticleDOI
Ketogenic Diet for Refractory Childhood Epilepsy: Beyond Seizures Control, the Experience of a Portuguese Pediatric Centre.
Inês Romão Luz,Cristina Silva Pereira,Paula Garcia,Fátima Ferreira,Ana Faria,Cristiane Macedo,Luísa Diogo,Conceição Robalo +7 more
TL;DR: Beyond seizure control, patients experienced a marked improvement in behavior and awareness, and it is necessary to develop strategies to increase the adherence of families to the ketogenic diet.
Journal ArticleDOI
Lung-restricted inhibition of Janus kinase 1 is effective in rodent models of asthma.
Hart S. Dengler,Xiumin Wu,Ivan Peng,Cornelia H. Rinderknecht,Youngsu Kwon,Eric Suto,Pawan Bir Kohli,Marya Liimatta,Kathy Barrett,Julia Lloyd,Gary Cain,Mike Briggs,Stephanie Addo,Gary Salmon,Savita Ubhayakar,Gauri Deshmukh,Sheerin K. Shahidi-Latham,Cristine M. Quiason-Huynh,Janet Jackman,John Liu,Nicholas Charles Ray,Simon Charles Goodacre,Adam R. Johnson,Brent S. McKenzie,Wyne P. Lee,Mark Zak,Jane R. Kenny,Nico Ghilardi +27 more
TL;DR: The data show that local inhibition of Jak1 in the lung can suppress lung inflammation without systemic Jak inhibition in rodents, suggesting that this strategy might be effective for treating asthma.
Journal ArticleDOI
Is it time to move away from short-acting beta-agonists in asthma management?
Matthew J. Martin,Tim Harrison +1 more
TL;DR: Evidence suggests replacing SABA with fast-acting LABA/ICS as reliever therapy reduces asthma exacerbation risk and the time has come to move away from SABAs in asthma management.
Journal ArticleDOI
Severe asthma-perspectives from adult and pediatric pulmonology
Louise Fleming,Liam G Heaney +1 more
TL;DR: Bronchoscopic studies in children with severe asthma have demonstrated that these children are predominantly eosinophilic but the cytokine patterns do not fit the T2 high paradigm suggesting other steroid resistant pathways are driving the eos inophilic inflammation.
References
More filters
Journal ArticleDOI
The measurement of observer agreement for categorical data
J. R. Landis,Gary G. Koch +1 more
TL;DR: A general statistical methodology for the analysis of multivariate categorical data arising from observer reliability studies is presented and tests for interobserver bias are presented in terms of first-order marginal homogeneity and measures of interob server agreement are developed as generalized kappa-type statistics.
Book
Applied Logistic Regression
David W. Hosmer,Stanley Lemeshow +1 more
TL;DR: Hosmer and Lemeshow as discussed by the authors provide an accessible introduction to the logistic regression model while incorporating advances of the last decade, including a variety of software packages for the analysis of data sets.
Journal ArticleDOI
Applied Logistic Regression.
TL;DR: Applied Logistic Regression, Third Edition provides an easily accessible introduction to the logistic regression model and highlights the power of this model by examining the relationship between a dichotomous outcome and a set of covariables.
Journal ArticleDOI
A Guideline of Selecting and Reporting Intraclass Correlation Coefficients for Reliability Research
Terry K. Koo,Mae Y. Li +1 more
TL;DR: A practical guideline for clinical researchers to choose the correct form of ICC is provided and the best practice of reporting ICC parameters in scientific publications is suggested.
Related Papers (5)
Symptom perception and adherence to asthma controller medications.
Ruth Ohm,Lauren S. Aaronson +1 more