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@article{Alahmadi:2021:10.1016/j.chest.2021.02.023,
author = {Alahmadi, FH and Simpson, AJ and Gomez, C and Ericsson, M and Thörngren, J-O and Wheelock, C and Shaw, DE and Fleming, LJ and Roberts, G and Riley, J and Bates, S and Sousa, AR and Knowles, R and Bansal, AT and Corfield, J and Pandis, I and Sun, K and Bakke, PS and Caruso, M and Chanez, P and Dahlén, B and Horvath, I and Krug, N and Montuschi, P and Singer, F and Wagers, S and Adcock, IM and Djukanovic, R and Chung, KF and Sterk, PJ and Dahlen, S-E and Fowler, SJ and U-BIOPRED, Study Group},
doi = {10.1016/j.chest.2021.02.023},
journal = {Chest},
pages = {53--64},
title = {Medication adherence in patients with severe asthma prescribed oral corticosteroids in the U-BIOPRED cohort},
url = {http://dx.doi.org/10.1016/j.chest.2021.02.023},
volume = {160},
year = {2021}
}

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TY  - JOUR
AB  - BACKGROUND: Whilst estimates of sub-optimal adherence to oral corticosteroids in asthma range from 30 to 50%, no ideal method for measurement exists; the impact of poor adherence in severe asthma is likely to be particularly high. RESEARCH QUESTIONS: 1. What is the prevalence of suboptimal adherence detected using self-reporting and direct measures? 2. Is suboptimal adherence associated with disease activity? STUDY DESIGN AND METHODS: Data were included from individuals with severe asthma taking part in the U-BIOPRED study prescribed daily oral corticosteroids. Participants completed the MARS, a five-item questionnaire used to grade adherence on a scale from 1 to 5, and provided a urine sample for analysis of prednisolone and metabolites by liquid-chromatography mass spectrometry. RESULTS: Data from 166 participants were included in this study, mean (SD) age 54.2 (11.9) years, FEV1 65.1 (20.5) % predicted, 58% female. 37% completing the MARS reported sub-optimal adherence, and 43% with urinary corticosteroid data did not have detectable prednisolone or metabolites in their urine. Good adherence by both methods was detected in 35% participants who had both performed; adherence detection did not match between methods in 53%. Self-reported high-adherers had better asthma control and quality of life, whereas directly-measured high-adherers had lower blood eosinophils. INTERPRETATION: Low adherence is a common problem in severe asthma, whether measured directly or self-reported. We report poor agreement between the two methods suggesting some disassociation between self-assessment of medication adherence and regular oral corticosteroid use, which suggests that each approach may provide complementary information in clinical practice.
AU  - Alahmadi,FH
AU  - Simpson,AJ
AU  - Gomez,C
AU  - Ericsson,M
AU  - Thörngren,J-O
AU  - Wheelock,C
AU  - Shaw,DE
AU  - Fleming,LJ
AU  - Roberts,G
AU  - Riley,J
AU  - Bates,S
AU  - Sousa,AR
AU  - Knowles,R
AU  - Bansal,AT
AU  - Corfield,J
AU  - Pandis,I
AU  - Sun,K
AU  - Bakke,PS
AU  - Caruso,M
AU  - Chanez,P
AU  - Dahlén,B
AU  - Horvath,I
AU  - Krug,N
AU  - Montuschi,P
AU  - Singer,F
AU  - Wagers,S
AU  - Adcock,IM
AU  - Djukanovic,R
AU  - Chung,KF
AU  - Sterk,PJ
AU  - Dahlen,S-E
AU  - Fowler,SJ
AU  - U-BIOPRED,Study Group
DO  - 10.1016/j.chest.2021.02.023
EP  - 64
PY  - 2021///
SN  - 0012-3692
SP  - 53
TI  - Medication adherence in patients with severe asthma prescribed oral corticosteroids in the U-BIOPRED cohort
T2  - Chest
UR  - http://dx.doi.org/10.1016/j.chest.2021.02.023
UR  - https://www.ncbi.nlm.nih.gov/pubmed/33610577
UR  - https://www.sciencedirect.com/science/article/pii/S0012369221002889?via%3Dihub
UR  - http://hdl.handle.net/10044/1/87745
VL  - 160
ER  -

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