Improvement of asthma control with a breath-actuated pressurised metred dose inhaler (BAI): a prescribing claims study of 5556 patients using a traditional pressurised metred dose inhaler (MDI) or a breath-actuated device

David Brendan Price, Michael David Thomas, G. Mitchell, C. Niziol, R. Featherstone

Research output: Contribution to journalArticle

52 Citations (Scopus)

Abstract

A relationship has been reported between sub-optimal inhaler technique and control of asthma symptoms. Randomised controlled trials and systematic reviews may fail to accurately represent this relationship, by excluding patients who are unable to correctly use the reviewed devices. Breath actuated inhalers (BAls) are reported to be easier to use than metered dose inhalers (MDls). This study uses a large primary care medical record database (DIN-LINK) to examine the 'real-life' clinical effectiveness of a BAI vs. traditional MDIs. A comparison is made between the quantity of asthma-related medication A agonist, oral steroids and antibiotics) and healthcare resource use required by children (0-12 years) and adults (13 + years) using either the BAI or an MIDI over a 12-month period. Out of 5556 new asthma patients who met the inclusion criteria, 306 used a BAI and 5250 used a traditional MDI. Children and adults using the BAI received fewer prescriptions for all three medication types than those using a traditional MIDI (children: beta(2) agonists -18% P = 0.036, oral steroids -88% P < 0.05, antibiotics -68% P < 0.05 and adults: beta(2) agonists - 10.9% P = 0.179, oral steroids -51.2% P < 0.05, antibiotics - 195% P = 0.276). All prescription results reached statistical significance, with the exception of &beta;(2) agonist and antibiotic prescription numbers for adult patients. Children and adults using the BAI required less GP consultations for asthma (children -30.3%, P < 0.05 and adults -22.9%, P < 0.05) and less GP consultations for respiratory infections than those using a traditional MIDI (children -35.2%, P-0.001 and adults -10.4%, P = 0.236). Adults using the BAI required less outpatient appointments than adults using an MIDI (-43.7%, P = 0.166). All non-prescription resource results reached statistical significance with the exception of GP consultations for respiratory infections and outpatient visits in the adult group. In conclusion, children and adults using the BAI appear to have better asthma control than children and adults using an MDI as evidenced by fewer relief medication prescriptions and less healthcare resource use. (C) 2002 Elsevier Science Ltd. All rights reserved.

Original languageEnglish
Pages (from-to)12-19
Number of pages7
JournalRespiratory Medicine
Volume97
Issue number1
DOIs
Publication statusPublished - 2003

Keywords

  • inhaler
  • asthma
  • breath-actuated
  • beclomethasone
  • beta(2) agonists
  • salbutamol
  • control
  • resource use
  • Easi-Breathe (R)
  • INHALATION TECHNIQUE
  • CHILDREN
  • AEROSOL
  • MANAGEMENT
  • EDUCATION
  • DELIVERY
  • GINA

Cite this

@article{4a9f83b9f6304622a7692209337a0b72,
title = "Improvement of asthma control with a breath-actuated pressurised metred dose inhaler (BAI): a prescribing claims study of 5556 patients using a traditional pressurised metred dose inhaler (MDI) or a breath-actuated device",
abstract = "A relationship has been reported between sub-optimal inhaler technique and control of asthma symptoms. Randomised controlled trials and systematic reviews may fail to accurately represent this relationship, by excluding patients who are unable to correctly use the reviewed devices. Breath actuated inhalers (BAls) are reported to be easier to use than metered dose inhalers (MDls). This study uses a large primary care medical record database (DIN-LINK) to examine the 'real-life' clinical effectiveness of a BAI vs. traditional MDIs. A comparison is made between the quantity of asthma-related medication A agonist, oral steroids and antibiotics) and healthcare resource use required by children (0-12 years) and adults (13 + years) using either the BAI or an MIDI over a 12-month period. Out of 5556 new asthma patients who met the inclusion criteria, 306 used a BAI and 5250 used a traditional MDI. Children and adults using the BAI received fewer prescriptions for all three medication types than those using a traditional MIDI (children: beta(2) agonists -18{\%} P = 0.036, oral steroids -88{\%} P < 0.05, antibiotics -68{\%} P < 0.05 and adults: beta(2) agonists - 10.9{\%} P = 0.179, oral steroids -51.2{\%} P < 0.05, antibiotics - 195{\%} P = 0.276). All prescription results reached statistical significance, with the exception of &beta;(2) agonist and antibiotic prescription numbers for adult patients. Children and adults using the BAI required less GP consultations for asthma (children -30.3{\%}, P < 0.05 and adults -22.9{\%}, P < 0.05) and less GP consultations for respiratory infections than those using a traditional MIDI (children -35.2{\%}, P-0.001 and adults -10.4{\%}, P = 0.236). Adults using the BAI required less outpatient appointments than adults using an MIDI (-43.7{\%}, P = 0.166). All non-prescription resource results reached statistical significance with the exception of GP consultations for respiratory infections and outpatient visits in the adult group. In conclusion, children and adults using the BAI appear to have better asthma control than children and adults using an MDI as evidenced by fewer relief medication prescriptions and less healthcare resource use. (C) 2002 Elsevier Science Ltd. All rights reserved.",
keywords = "inhaler, asthma, breath-actuated, beclomethasone, beta(2) agonists, salbutamol, control, resource use, Easi-Breathe (R), INHALATION TECHNIQUE, CHILDREN, AEROSOL, MANAGEMENT, EDUCATION, DELIVERY, GINA",
author = "Price, {David Brendan} and Thomas, {Michael David} and G. Mitchell and C. Niziol and R. Featherstone",
year = "2003",
doi = "10.1053/rmed.2002.1426",
language = "English",
volume = "97",
pages = "12--19",
journal = "Respiratory Medicine",
issn = "0954-6111",
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TY - JOUR

T1 - Improvement of asthma control with a breath-actuated pressurised metred dose inhaler (BAI): a prescribing claims study of 5556 patients using a traditional pressurised metred dose inhaler (MDI) or a breath-actuated device

AU - Price, David Brendan

AU - Thomas, Michael David

AU - Mitchell, G.

AU - Niziol, C.

AU - Featherstone, R.

PY - 2003

Y1 - 2003

N2 - A relationship has been reported between sub-optimal inhaler technique and control of asthma symptoms. Randomised controlled trials and systematic reviews may fail to accurately represent this relationship, by excluding patients who are unable to correctly use the reviewed devices. Breath actuated inhalers (BAls) are reported to be easier to use than metered dose inhalers (MDls). This study uses a large primary care medical record database (DIN-LINK) to examine the 'real-life' clinical effectiveness of a BAI vs. traditional MDIs. A comparison is made between the quantity of asthma-related medication A agonist, oral steroids and antibiotics) and healthcare resource use required by children (0-12 years) and adults (13 + years) using either the BAI or an MIDI over a 12-month period. Out of 5556 new asthma patients who met the inclusion criteria, 306 used a BAI and 5250 used a traditional MDI. Children and adults using the BAI received fewer prescriptions for all three medication types than those using a traditional MIDI (children: beta(2) agonists -18% P = 0.036, oral steroids -88% P < 0.05, antibiotics -68% P < 0.05 and adults: beta(2) agonists - 10.9% P = 0.179, oral steroids -51.2% P < 0.05, antibiotics - 195% P = 0.276). All prescription results reached statistical significance, with the exception of &beta;(2) agonist and antibiotic prescription numbers for adult patients. Children and adults using the BAI required less GP consultations for asthma (children -30.3%, P < 0.05 and adults -22.9%, P < 0.05) and less GP consultations for respiratory infections than those using a traditional MIDI (children -35.2%, P-0.001 and adults -10.4%, P = 0.236). Adults using the BAI required less outpatient appointments than adults using an MIDI (-43.7%, P = 0.166). All non-prescription resource results reached statistical significance with the exception of GP consultations for respiratory infections and outpatient visits in the adult group. In conclusion, children and adults using the BAI appear to have better asthma control than children and adults using an MDI as evidenced by fewer relief medication prescriptions and less healthcare resource use. (C) 2002 Elsevier Science Ltd. All rights reserved.

AB - A relationship has been reported between sub-optimal inhaler technique and control of asthma symptoms. Randomised controlled trials and systematic reviews may fail to accurately represent this relationship, by excluding patients who are unable to correctly use the reviewed devices. Breath actuated inhalers (BAls) are reported to be easier to use than metered dose inhalers (MDls). This study uses a large primary care medical record database (DIN-LINK) to examine the 'real-life' clinical effectiveness of a BAI vs. traditional MDIs. A comparison is made between the quantity of asthma-related medication A agonist, oral steroids and antibiotics) and healthcare resource use required by children (0-12 years) and adults (13 + years) using either the BAI or an MIDI over a 12-month period. Out of 5556 new asthma patients who met the inclusion criteria, 306 used a BAI and 5250 used a traditional MDI. Children and adults using the BAI received fewer prescriptions for all three medication types than those using a traditional MIDI (children: beta(2) agonists -18% P = 0.036, oral steroids -88% P < 0.05, antibiotics -68% P < 0.05 and adults: beta(2) agonists - 10.9% P = 0.179, oral steroids -51.2% P < 0.05, antibiotics - 195% P = 0.276). All prescription results reached statistical significance, with the exception of &beta;(2) agonist and antibiotic prescription numbers for adult patients. Children and adults using the BAI required less GP consultations for asthma (children -30.3%, P < 0.05 and adults -22.9%, P < 0.05) and less GP consultations for respiratory infections than those using a traditional MIDI (children -35.2%, P-0.001 and adults -10.4%, P = 0.236). Adults using the BAI required less outpatient appointments than adults using an MIDI (-43.7%, P = 0.166). All non-prescription resource results reached statistical significance with the exception of GP consultations for respiratory infections and outpatient visits in the adult group. In conclusion, children and adults using the BAI appear to have better asthma control than children and adults using an MDI as evidenced by fewer relief medication prescriptions and less healthcare resource use. (C) 2002 Elsevier Science Ltd. All rights reserved.

KW - inhaler

KW - asthma

KW - breath-actuated

KW - beclomethasone

KW - beta(2) agonists

KW - salbutamol

KW - control

KW - resource use

KW - Easi-Breathe (R)

KW - INHALATION TECHNIQUE

KW - CHILDREN

KW - AEROSOL

KW - MANAGEMENT

KW - EDUCATION

KW - DELIVERY

KW - GINA

U2 - 10.1053/rmed.2002.1426

DO - 10.1053/rmed.2002.1426

M3 - Article

VL - 97

SP - 12

EP - 19

JO - Respiratory Medicine

JF - Respiratory Medicine

SN - 0954-6111

IS - 1

ER -