Can the Turbu+™ adherence programme contribute to improved adherence to asthma controller treatment in Italy?

G. Rumi, F. Braido, G.W. Canonica, J.M. Foster, N.H. Chavannes, C. Columbro, G. Valenti, R. Contiguglia, E. Rapsomaniki, M.A. De Blas, J.W.H. Kocks



Introduction and objective Electronic inhalers providing reminders and adherence feedback have improved adherence to asthma controller medication in clinical trials. We investigated a community implementation of the Turbu+™ programme, designed to support adherence to budesonide/ formoterol (BUD/FORM, Symbicort®) Turbuhaler®. Methods Asthma patients prescribed BUD/FORM maintenance therapy (1-BID or 2-BID) or maintenance and reliever therapy (1-BID+as needed or 2-BID+as needed) received training on Turbu+™ in secondary care centres across Italy. An electronic device attached to their inhaler for ≥90 days securely uploaded adherence data to a smartphone app enabling patients to view their controller use. Average medication adherence was calculated based on maintenance regimens (2 puffs/day for 1-BID regimens, 4 puffs/day for 2-BID regimens) and defined as proportion of daily maintenance inhalations taken as prescribed (number recorded actuations per day/number maintenance puffs prescribed per day) averaged over the monitoring period. Proportion of adherent days was defined as the proportion of days that all prescribed maintenance doses were taken in a given day. A Wilcoxon test compared proportion of adherent days between patients in the maintenance vs maintenance and reliever treatment regimens of a given dose (1-BID or 2-BID). Results In 316 patients, mean (±SD) number of days monitored was 156.9 (±53.7): 1-BID, 158.8 (±50.9); 1-BID+as needed, 154.2 (±53.2); 2-BID, 149.4 (±62.7) and 2-BID+as needed, 162.3 (±53.5). Median (IQR) number of doses/day were: 1-BID, 2 doses (1-2); 1-BID+as needed, 2 doses (1-2); 2-BID, 4 doses (2-4) and 2-BID+as needed, 4 doses (2-4). Average medication adherence was 71% overall and similar across treatment groups (figure 1). Proportion of adherent days was 57% of days overall and higher with maintenance and reliever therapy (1-BID+as needed vs 1-BID; p12 doses/day) were low (∼0.05% person-days). Conclusion Observed controller adherence rate of patients in the Turbu+™ programme (71%) was higher than that previously reported in Italy,1 although comparisons between this small study in selected sites and a large unselected national survey are difficult. Further prospective research of the Turbu +™ programme will determine its contribution to improved adherence. (Figure Presented).
Originele taal-2English
Aantal pagina's2
StatusPublished - 1-dec.-2018

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