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Does a tailored intervention to promote adherence in patients with chronic lung disease affect exacerbations? A randomized controlled trial

Gregoriano, Claudia and Dieterle, Thomas and Breitenstein, Anna-Lisa and Dürr, Selina and Baum, Amanda and Giezendanner, Stéphanie and Maier, Sabrina and Leuppi-Taegtmeyer, Anne and Arnet, Isabelle and Hersberger, Kurt E. and Leuppi, Jörg D.. (2019) Does a tailored intervention to promote adherence in patients with chronic lung disease affect exacerbations? A randomized controlled trial. Respiratory research, 20 (1). p. 273.

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Official URL: https://edoc.unibas.ch/74542/

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Abstract

Poor medication-adherence is common in chronic lung patients, resulting in reduced health-outcomes and increased healthcare-costs. This study aimed to investigate the impact of an acoustic reminder and support calls on adherence to inhaled therapy in asthma and COPD patients and to determine their effect on exacerbations.; This single-blinded randomized controlled trial investigated asthma and COPD patients during 6 months in an ambulatory setting. The intervention consisted of daily alarm clock and support phone calls, whenever use of rescue medication doubled or inhaled medication was not taken as prescribed. Primary outcome was time to next exacerbation. Frequency of exacerbations, adherence to inhaled medication and quality of life scores were secondary outcomes. Cox and Poisson regression were used to determine intervention effect on time to exacerbation and frequency of exacerbations, respectively.; Seventy-five participants were assigned to the intervention group and 74 to usual follow-up care. During a median follow-up of 6.2 months, 22 and 28% in the intervention and control groups respectively, experienced at least one exacerbation. Intervention had no effect on time to first exacerbation (HR 0.65, 95% CI 0.21 to 2.07, P = .24), but showed a trend toward a 39% decreased frequency of exacerbations (RR = 0.61, 95% CI 0.35 to 1.03, P = .070) for the adjusted models, respectively. The intervention group had significantly more days with 80-100% taking adherence regarding puff inhalers (82 ± 14% vs. 60 ± 30%, P < .001) and dry powder capsules (90 ± .10% vs. 80 ± 21%, P = .01). Timing adherence in participants using puff inhalers was higher in the intervention group (69 ± 25% vs. 51 ± 33%, P < .001). No significant differences in QoL were found between the two groups.; Participants assigned to the intervention group had significantly better taking and timing adherence of inhaled medication resulting in a trend towards a decreased frequency of exacerbations. However, no effect on time to next exacerbation was observed.; ClinicalTrials.gov: NCT02386722, Registered 14 February 2014.
Faculties and Departments:05 Faculty of Science > Departement Pharmazeutische Wissenschaften > Pharmazie > Pharmaceutical Care (Hersberger)
UniBasel Contributors:Arnet, Isabelle and Gregoriano, Claudia and Hersberger, Kurt E. and Leuppi, Jörg D. and Leuppi-Taegtmeyer, Anne
Item Type:Article, refereed
Article Subtype:Research Article
ISSN:1465-993X
Note:Publication type according to Uni Basel Research Database: Journal article
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Last Modified:13 Apr 2020 13:26
Deposited On:13 Apr 2020 13:26

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