Source: International Congress 2015 – Best abstracts in chronic care
Disease area: Airway diseases

Abstract

Background: Poor adherence is a common cause of poor asthma control but clinical tools for assessment of adherence to asthma medications are lacking.Objective: To assess the usefulness of self-reported adherence measures in a clinically relevant population of asthma patients.Methods: The MAPOut II study was a cross-sectional study of all asthma patients referred to an outpatient respiratory clinic for specialist management over 12 months. The present analysis included patients treated with inhaled corticosteroids. Self-reported adherence was assessed by interview as days/week (0/7) and by the MARS-A score. Poor adherence was defined as a 0/7 score < 80 % and <4.5 on the MARS-A score. Asthma control was assessed with the ACQ score, airway hyperresponsiveness (AHR) with mannitol and methacholine challenge tests.Results: Among 73 asthma patients on regular ICS, 17 (23%) self-reported poor adherence (0/7 < 80%) and 21 (29%) had a MARS_A score < 4.5. Poor adherence assessed by the 0/7 score was associated with more AHR to mannitol (RDR mannitol: Mean 0.11 (95C.I: 0.03-0.26) vs. patients with good adherence (GA): Mean 0.04 (95C.I: 0.02-0.05) p=0.024) and a tendency to more AHR to methacholine (RDR methacholine: PA 18.5 (95C.I. 7.9-43.1) vs. GA 8.2 (95C.I. 5.4-12.4) p=0.08). Furthermore, patients with poor adherence tended to have increased reversibility (12.9 % vs. 7.1 % P=0.08). In comparison, patients with poor adherence according to the MARS-A score did not have more FeNO, reversibility or AHR than adherent patients.Conclusion: The 0/7 score is an easily applicable clinical tool, which associates self-reported poor adherence in asthma patients with AHR.


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Christian Woehlk (Copenhagen, Denmark), Christian Woehlk, Anna Von Bülow, Asger Sverrild, Vibeke Backer, Celeste Porsbjerg. Self-reported lack of adherence is associated with increased airway hyperresponsivness in asthma. Eur Respir J 2015; 46: Suppl. 59, 3069

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