Poor adherence with inhaled corticosteroids for asthma: can using a single inhaler containing budesonide and formoterol help?

Poor adherence with inhaled corticosteroids is an important problem in asthma management. Previous approaches to improving adherence have had limited success. To determine whether treatment with a single inhaler containing a long-acting beta(2)-agonist and a corticosteroid for maintenance treatment...

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Bibliographic Details
Published in:British journal of general practice 2008-01, Vol.58 (546), p.37-43
Main Authors: Sovani, Milind P, Whale, Christopher I, Oborne, Janet, Cooper, Sue, Mortimer, Kevin, Ekström, Tommy, Tattersfield, Anne E, Harrison, Timothy W
Format: Article
Language:English
Subjects:
Administration, Inhalation
Adrenal Cortex Hormones - therapeutic use
Adult
Asthma - drug therapy
Asthma - physiopathology
Bronchodilator Agents - therapeutic use
Budesonide - therapeutic use
Drug Therapy, Combination
Ethanolamines - therapeutic use
Female
Forced Expiratory Volume
Formoterol Fumarate
Humans
Male
Original Papers
Patient Compliance
Quality of Life
Surveys and Questionnaires
Treatment Outcome
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Summary:Poor adherence with inhaled corticosteroids is an important problem in asthma management. Previous approaches to improving adherence have had limited success. To determine whether treatment with a single inhaler containing a long-acting beta(2)-agonist and a corticosteroid for maintenance treatment and symptom relief can overcome the problem of poor adherence with inhaled corticosteroids. Randomised, parallel group, open-label trial. Forty-four general practices in Nottinghamshire. Participants who used less than 70% of their prescribed dose of inhaled corticosteroid and had poorly controlled asthma were randomised to budesonide 200 microg one puff twice daily plus their own short-acting beta(2)-agonist as required (control group), or budesonide/formoterol 200/6 microg one puff once daily and as required (active group) for 6 months. The primary outcome was inhaled corticosteroid dose. Seventy-one participants (35 control, 36 active group) were randomised. Adherence with budesonide in the control group was approximately 60% of the prescribed dose. Participants in the active group used approximately 80% more budesonide than participants in the control group (448 versus 252 microg/day, mean difference 196 mug, 95% confidence interval 113 to 279; P
ISSN:0960-1643
1478-5242
DOI:10.3399/bjgp08X263802