Patterns of corticosteroid medication use: Non-adherence can be effective in milder asthma

C.J. Greaves, M.E. Hyland, D.M.G. Halpin, S. Blake, D. Seamark

Research output: Contribution to journalArticlepeer-review

17 Citations (Scopus)

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.
Original languageEnglish
Pages (from-to)99-105
Number of pages6
JournalPrimary Care Respiratory Journal
Volume14
Issue number2
DOIs
Publication statusPublished - 1 Apr 2005

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