Establishing the relationship of inhaler satisfaction, treatment adherence, and patient outcomes: A prospective, real-world, cross-sectional survey of US adult asthma patients and physicians

David Price, Brooke Harrow, Mark Small, James Pike, Victoria Higgins*

*Corresponding author for this work

Research output: Contribution to journalArticle

29 Citations (Scopus)
4 Downloads (Pure)

Abstract

Background: Inhaled asthma medications are the mainstay of treatment for chronic asthma. However, nonadherence rates for long-term inhaler therapy among adults are estimated to exceed 50 %. Nonadherence is associated with unfavorable clinical outcomes and diminished quality of life. Research suggests that adherence is associated with patients' satisfaction with their treatment regimen and other factors, such as concomitant allergic rhinitis and tobacco use. Methods: This prospective, cross-sectional survey of physicians and their patients evaluated the relationship between patient satisfaction with attributes of inhaler devices, treatment adherence, and clinical outcomes. Primary care and specialist physicians completed a physician-reported patient record form for patients with a confirmed asthma diagnosis. Patients for whom a physician-reported form was completed were invited to complete a patient-reported form. Both surveys collected information about demographics, symptoms, exacerbation history, treatment, smoking status, comorbidities, type of inhaler device, and treatment adherence. Patients also indicated the degree to which they were satisfied with attributes of their currently prescribed inhaler device(s). Partial least squares path modeling quantified relationships between latent variables and clinical outcomes. Results: A total of 243 patients were included in our analysis and 41 % had poorly controlled asthma. More favorable clinical outcomes were significantly associated with greater patient satisfaction with drug delivery (P∈=∈0.002), higher medication adherence (P∈=∈0.049), no history of tobacco use (P∈<∈0.001), and absence of comorbid allergic rhinitis (P∈=∈0.005). Attributes associated with device satisfaction included patient perceptions of consistency in the amount of drug delivery to the lungs, ease of use, and feedback about the number of remaining doses. Conclusions: Higher patient satisfaction with their asthma drug delivery inhaler device is a significant predictor of more favorable clinical outcomes while allergic rhinitis and smoking history were negatively associated with optimal control of asthma. These findings provide clinicians with opportunities to improve patients' clinical outcomes by tailoring choice of inhaler device therapy and providing education about the correct way to use the device to ensure optimal outcomes. Patients will likely benefit from medical therapy to manage comorbid allergic rhinitis and smoking cessation interventions. Patients unable to stop smoking may require alternative medical therapies to improve their clinical outcomes.

Original languageEnglish
Article number26
JournalWorld Allergy Organization Journal
Volume8
DOIs
Publication statusPublished - 10 Sep 2015

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Nebulizers and Vaporizers
Patient Compliance
Asthma
Cross-Sectional Studies
Physicians
Patient Satisfaction
Equipment and Supplies
Therapeutics
Smoking
Tobacco Use
History
Pharmaceutical Preparations
Medication Adherence
Primary Care Physicians
Smoking Cessation
Complementary Therapies
Least-Squares Analysis
Comorbidity
Quality of Life
Demography

Keywords

  • Adherence
  • Allergic rhinitis
  • Asthma
  • Inhaler device
  • Patient outcomes
  • Treatment satisfaction

ASJC Scopus subject areas

  • Immunology and Allergy

Cite this

@article{6cdbacc8523449c39421c00170082e05,
title = "Establishing the relationship of inhaler satisfaction, treatment adherence, and patient outcomes: A prospective, real-world, cross-sectional survey of US adult asthma patients and physicians",
abstract = "Background: Inhaled asthma medications are the mainstay of treatment for chronic asthma. However, nonadherence rates for long-term inhaler therapy among adults are estimated to exceed 50 {\%}. Nonadherence is associated with unfavorable clinical outcomes and diminished quality of life. Research suggests that adherence is associated with patients' satisfaction with their treatment regimen and other factors, such as concomitant allergic rhinitis and tobacco use. Methods: This prospective, cross-sectional survey of physicians and their patients evaluated the relationship between patient satisfaction with attributes of inhaler devices, treatment adherence, and clinical outcomes. Primary care and specialist physicians completed a physician-reported patient record form for patients with a confirmed asthma diagnosis. Patients for whom a physician-reported form was completed were invited to complete a patient-reported form. Both surveys collected information about demographics, symptoms, exacerbation history, treatment, smoking status, comorbidities, type of inhaler device, and treatment adherence. Patients also indicated the degree to which they were satisfied with attributes of their currently prescribed inhaler device(s). Partial least squares path modeling quantified relationships between latent variables and clinical outcomes. Results: A total of 243 patients were included in our analysis and 41 {\%} had poorly controlled asthma. More favorable clinical outcomes were significantly associated with greater patient satisfaction with drug delivery (P∈=∈0.002), higher medication adherence (P∈=∈0.049), no history of tobacco use (P∈<∈0.001), and absence of comorbid allergic rhinitis (P∈=∈0.005). Attributes associated with device satisfaction included patient perceptions of consistency in the amount of drug delivery to the lungs, ease of use, and feedback about the number of remaining doses. Conclusions: Higher patient satisfaction with their asthma drug delivery inhaler device is a significant predictor of more favorable clinical outcomes while allergic rhinitis and smoking history were negatively associated with optimal control of asthma. These findings provide clinicians with opportunities to improve patients' clinical outcomes by tailoring choice of inhaler device therapy and providing education about the correct way to use the device to ensure optimal outcomes. Patients will likely benefit from medical therapy to manage comorbid allergic rhinitis and smoking cessation interventions. Patients unable to stop smoking may require alternative medical therapies to improve their clinical outcomes.",
keywords = "Adherence, Allergic rhinitis, Asthma, Inhaler device, Patient outcomes, Treatment satisfaction",
author = "David Price and Brooke Harrow and Mark Small and James Pike and Victoria Higgins",
note = "Date of Acceptance: 26/06/2015 Acknowledgements The disease-specific program, on which the analyses were based, was designed and run by Adelphi Real World. The program was supported by a number of pharmaceutical companies, including Meda Pharmaceuticals. This specific analysis, together with this publication, was supported by Meda Pharmaceuticals. The decision to publish was made jointly by all authors cited. Medical writing support and literature searching was provided by Carole Alison Chrvala, PhD of Health Matters, Inc.",
year = "2015",
month = "9",
day = "10",
doi = "10.1186/s40413-015-0075-y",
language = "English",
volume = "8",
journal = "World Allergy Organization Journal",
issn = "1939-4551",
publisher = "Lippincott Williams and Wilkins",

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T1 - Establishing the relationship of inhaler satisfaction, treatment adherence, and patient outcomes

T2 - A prospective, real-world, cross-sectional survey of US adult asthma patients and physicians

AU - Price, David

AU - Harrow, Brooke

AU - Small, Mark

AU - Pike, James

AU - Higgins, Victoria

N1 - Date of Acceptance: 26/06/2015 Acknowledgements The disease-specific program, on which the analyses were based, was designed and run by Adelphi Real World. The program was supported by a number of pharmaceutical companies, including Meda Pharmaceuticals. This specific analysis, together with this publication, was supported by Meda Pharmaceuticals. The decision to publish was made jointly by all authors cited. Medical writing support and literature searching was provided by Carole Alison Chrvala, PhD of Health Matters, Inc.

PY - 2015/9/10

Y1 - 2015/9/10

N2 - Background: Inhaled asthma medications are the mainstay of treatment for chronic asthma. However, nonadherence rates for long-term inhaler therapy among adults are estimated to exceed 50 %. Nonadherence is associated with unfavorable clinical outcomes and diminished quality of life. Research suggests that adherence is associated with patients' satisfaction with their treatment regimen and other factors, such as concomitant allergic rhinitis and tobacco use. Methods: This prospective, cross-sectional survey of physicians and their patients evaluated the relationship between patient satisfaction with attributes of inhaler devices, treatment adherence, and clinical outcomes. Primary care and specialist physicians completed a physician-reported patient record form for patients with a confirmed asthma diagnosis. Patients for whom a physician-reported form was completed were invited to complete a patient-reported form. Both surveys collected information about demographics, symptoms, exacerbation history, treatment, smoking status, comorbidities, type of inhaler device, and treatment adherence. Patients also indicated the degree to which they were satisfied with attributes of their currently prescribed inhaler device(s). Partial least squares path modeling quantified relationships between latent variables and clinical outcomes. Results: A total of 243 patients were included in our analysis and 41 % had poorly controlled asthma. More favorable clinical outcomes were significantly associated with greater patient satisfaction with drug delivery (P∈=∈0.002), higher medication adherence (P∈=∈0.049), no history of tobacco use (P∈<∈0.001), and absence of comorbid allergic rhinitis (P∈=∈0.005). Attributes associated with device satisfaction included patient perceptions of consistency in the amount of drug delivery to the lungs, ease of use, and feedback about the number of remaining doses. Conclusions: Higher patient satisfaction with their asthma drug delivery inhaler device is a significant predictor of more favorable clinical outcomes while allergic rhinitis and smoking history were negatively associated with optimal control of asthma. These findings provide clinicians with opportunities to improve patients' clinical outcomes by tailoring choice of inhaler device therapy and providing education about the correct way to use the device to ensure optimal outcomes. Patients will likely benefit from medical therapy to manage comorbid allergic rhinitis and smoking cessation interventions. Patients unable to stop smoking may require alternative medical therapies to improve their clinical outcomes.

AB - Background: Inhaled asthma medications are the mainstay of treatment for chronic asthma. However, nonadherence rates for long-term inhaler therapy among adults are estimated to exceed 50 %. Nonadherence is associated with unfavorable clinical outcomes and diminished quality of life. Research suggests that adherence is associated with patients' satisfaction with their treatment regimen and other factors, such as concomitant allergic rhinitis and tobacco use. Methods: This prospective, cross-sectional survey of physicians and their patients evaluated the relationship between patient satisfaction with attributes of inhaler devices, treatment adherence, and clinical outcomes. Primary care and specialist physicians completed a physician-reported patient record form for patients with a confirmed asthma diagnosis. Patients for whom a physician-reported form was completed were invited to complete a patient-reported form. Both surveys collected information about demographics, symptoms, exacerbation history, treatment, smoking status, comorbidities, type of inhaler device, and treatment adherence. Patients also indicated the degree to which they were satisfied with attributes of their currently prescribed inhaler device(s). Partial least squares path modeling quantified relationships between latent variables and clinical outcomes. Results: A total of 243 patients were included in our analysis and 41 % had poorly controlled asthma. More favorable clinical outcomes were significantly associated with greater patient satisfaction with drug delivery (P∈=∈0.002), higher medication adherence (P∈=∈0.049), no history of tobacco use (P∈<∈0.001), and absence of comorbid allergic rhinitis (P∈=∈0.005). Attributes associated with device satisfaction included patient perceptions of consistency in the amount of drug delivery to the lungs, ease of use, and feedback about the number of remaining doses. Conclusions: Higher patient satisfaction with their asthma drug delivery inhaler device is a significant predictor of more favorable clinical outcomes while allergic rhinitis and smoking history were negatively associated with optimal control of asthma. These findings provide clinicians with opportunities to improve patients' clinical outcomes by tailoring choice of inhaler device therapy and providing education about the correct way to use the device to ensure optimal outcomes. Patients will likely benefit from medical therapy to manage comorbid allergic rhinitis and smoking cessation interventions. Patients unable to stop smoking may require alternative medical therapies to improve their clinical outcomes.

KW - Adherence

KW - Allergic rhinitis

KW - Asthma

KW - Inhaler device

KW - Patient outcomes

KW - Treatment satisfaction

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