Effectiveness of Same Versus Mixed Asthma Inhaler Devices: A Retrospective Observational Study in Primary Care
Allergy, Asthma & Immunology Research
;
: 184-191, 2012.
Article
Dans Anglais
| WPRIM
| ID: wpr-74808
ABSTRACT
PURPOSE:
Correct use of inhaler devices is fundamental to effective asthma management but represents an important challenge for patients. The correct inhalation manoeuvre differs markedly for different inhaler types. The objective of this study was to compare outcomes for patients prescribed the same inhaler device versus mixed device types for asthma controller and reliever therapy.METHODS:
This retrospective observational study identified patients with asthma (ages 4-80 years) in a large primary care database who were prescribed an inhaled corticosteroid (ICS) for the first time. We compared outcomes for patients prescribed the same breath-actuated inhaler (BAI) for ICS controller and salbutamol reliever versus mixed devices (BAI for controller and pressurised metered-dose inhaler [pMDI] for reliever). The 2-year study included 1 baseline year before the ICS prescription (to identify and correct for confounding factors) and 1 outcome year. Endpoints were asthma control (defined as no hospital attendance for asthma, oral corticosteroids, or antibiotics for lower respiratory tract infection) and severe exacerbations (hospitalisation or oral corticosteroids for asthma).RESULTS:
Patients prescribed the same device (n=3,428) were significantly more likely to achieve asthma control (adjusted odds ratio, 1.15; 95% confidence interval [CI], 1.02-1.28) and recorded significantly lower severe exacerbation rates (adjusted rate ratio, 0.79; 95% CI, 0.68-0.93) than those prescribed mixed devices (n=5,452).CONCLUSIONS:
These findings suggest that, when possible, the same device should be prescribed for both ICS and reliever therapy when patients are initiating ICS.
Texte intégral:
Disponible
Indice:
WPRIM (Pacifique occidental)
Sujet Principal:
Soins de santé primaires
/
Appareil respiratoire
/
Asthme
/
Nébuliseurs et vaporisateurs
/
Odds ratio
/
Inspiration
/
Études rétrospectives
/
Hormones corticosurrénaliennes
/
Salbutamol
/
Ordonnances
Type d'étude:
Etude d'étiologie
/
Étude observationnelle
/
Étude pronostique
Limites du sujet:
Humains
langue:
Anglais
Texte intégral:
Allergy, Asthma & Immunology Research
Année:
2012
Type:
Article
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