Abstract
Aims:
To identify specific patterns of corticosteroid use and examine their relationship with asthma outcomes.
Methods:
An adherence questionnaire was developed and applied in a population-based observational survey; this compared unscheduled care visits and asthma quality of life for adherent and non-adherent patient groups within 176 patients from a semi-rural UK practice.
Results:
Three main patterns of medication use were identified: Regular; Regular-but-less (Low-Dosing); and Symptom-Directed variation. For mild-to-moderate asthma (BTS treatment step 2), non-adherence produced acceptable outcomes, not significantly different from outcomes for adherent patients. For more severe asthma, regular adherence was more effective, resulting in significantly less unscheduled visits.
Conclusions:
The results suggest that flexible ‘symptom-directed’ medication use and patient-initiated dose reduction may be viable alternatives to regular medication for a number of lower severity patients. For milder asthma, clinicians should perhaps focus their efforts on patients with poor asthma outcomes, rather than poor adherence.
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Greaves, C., Hyland, M., Halpin, D. et al. Patterns of corticosteroid medication use: non-adherence can be effective in milder asthma. Prim Care Respir J 14, 99–105 (2005). https://doi.org/10.1016/j.pcrj.2004.09.005
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DOI: https://doi.org/10.1016/j.pcrj.2004.09.005
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