Show simple item record

dc.contributor.authorMokoka, Matshediso C
dc.contributor.authorLombard, Lorna
dc.contributor.authorMacHale, Elaine M
dc.contributor.authorWalsh, Joanne
dc.contributor.authorCushen, Breda
dc.contributor.authorSulaiman, Imran
dc.contributor.authorCarthy, Damien Mc
dc.contributor.authorBoland, Fiona
dc.contributor.authorDoyle, Frank
dc.contributor.authorHunt, Eoin
dc.contributor.authorMurphy, Desmond M
dc.contributor.authorFaul, John
dc.contributor.authorButler, Marcus
dc.contributor.authorHetherington, Kathy
dc.contributor.authorMark FitzGerald, J
dc.contributor.authorBoven, Job Fm van
dc.contributor.authorHeaney, Liam G
dc.contributor.authorReilly, Richard B
dc.contributor.authorCostello, Richard W
dc.date.accessioned2017-07-05T10:45:30Z
dc.date.available2017-07-05T10:45:30Z
dc.date.issued2017-06-15
dc.identifier.citationIn patients with severe uncontrolled asthma, does knowledge of adherence and inhaler technique using electronic monitoring improve clinical decision making? A protocol for a randomised controlled trial. 2017, 7 (6):e015367 BMJ Openen
dc.identifier.issn2044-6055
dc.identifier.pmid28619778
dc.identifier.doi10.1136/bmjopen-2016-015367
dc.identifier.urihttp://hdl.handle.net/10147/621478
dc.descriptionMany patients with asthma remain poorly controlled despite the use of inhaled corticosteroids and long-acting beta agonists. Poor control may arise from inadequate adherence, incorrect inhaler technique or because the condition is refractory. Without having an objective assessment of adherence, clinicians may inadvertently add extra medication instead of addressing adherence. This study aims to assess if incorporating objectively recorded adherence from the Inhaler Compliance Assessment (INCA) device and lung function into clinical decision making provides more cost-effective prescribing and improves outcomes.en
dc.description.abstractMany patients with asthma remain poorly controlled despite the use of inhaled corticosteroids and long-acting beta agonists. Poor control may arise from inadequate adherence, incorrect inhaler technique or because the condition is refractory. Without having an objective assessment of adherence, clinicians may inadvertently add extra medication instead of addressing adherence. This study aims to assess if incorporating objectively recorded adherence from the Inhaler Compliance Assessment (INCA) device and lung function into clinical decision making provides more cost-effective prescribing and improves outcomes.
dc.description.abstractThis prospective, randomised, multicentre study will compare the impact of using information on adherence to influence asthma treatment. Patients with severe uncontrolled asthma will be included. Data on adherence, inhaler technique and electronically recorded peak expiratory flow rate will be used to promote adherence and guide a clinical decision protocol to guide management in the active group. The control group will receive standard inhaler and adherence education. Medications will be adjusted using a protocol based on Global Initiativefor Asthma (GINA) recommendations. The primary outcome is the between-group difference in the proportion of patients who have refractory disease and are prescribed appropriate medications at the end of 32 weeks. A co-primary outcome is the difference between groups in the rate of adherence to salmeterol/fluticasone inhaler over the last 12 weeks. Secondary outcomes include changes in symptoms, lung function, type-2 cytokine biomarkers and clinical outcomes between both groups. Cost-effectiveness and cost-utility analyses of the INCA device intervention will be performed. The economic impact of a national implementation of the INCA-SUN programme will be evaluated.
dc.description.abstractThe results of the study will be published as a manuscript in peer-reviewed journals. The study has been approved by the ethics committees in the five participating hospitals.
dc.description.abstractNCT02307669; Pre-results.
dc.language.isoenen
dc.publisherBMJ Openen
dc.relation.urlhttp://bmjopen.bmj.com/content/7/6/e015367.longen
dc.rightsArchived with thanks to BMJ openen
dc.subjectASTHMAen
dc.subjectTREATMENT ADHERENCEen
dc.titleIn patients with severe uncontrolled asthma, does knowledge of adherence and inhaler technique using electronic monitoring improve clinical decision making? A protocol for a randomised controlled trial.en
dc.typeArticleen
dc.identifier.journalBMJ openen
refterms.dateFOA2018-08-27T22:38:46Z
html.description.abstractMany patients with asthma remain poorly controlled despite the use of inhaled corticosteroids and long-acting beta agonists. Poor control may arise from inadequate adherence, incorrect inhaler technique or because the condition is refractory. Without having an objective assessment of adherence, clinicians may inadvertently add extra medication instead of addressing adherence. This study aims to assess if incorporating objectively recorded adherence from the Inhaler Compliance Assessment (INCA) device and lung function into clinical decision making provides more cost-effective prescribing and improves outcomes.
html.description.abstractThis prospective, randomised, multicentre study will compare the impact of using information on adherence to influence asthma treatment. Patients with severe uncontrolled asthma will be included. Data on adherence, inhaler technique and electronically recorded peak expiratory flow rate will be used to promote adherence and guide a clinical decision protocol to guide management in the active group. The control group will receive standard inhaler and adherence education. Medications will be adjusted using a protocol based on Global Initiativefor Asthma (GINA) recommendations. The primary outcome is the between-group difference in the proportion of patients who have refractory disease and are prescribed appropriate medications at the end of 32 weeks. A co-primary outcome is the difference between groups in the rate of adherence to salmeterol/fluticasone inhaler over the last 12 weeks. Secondary outcomes include changes in symptoms, lung function, type-2 cytokine biomarkers and clinical outcomes between both groups. Cost-effectiveness and cost-utility analyses of the INCA device intervention will be performed. The economic impact of a national implementation of the INCA-SUN programme will be evaluated.
html.description.abstractThe results of the study will be published as a manuscript in peer-reviewed journals. The study has been approved by the ethics committees in the five participating hospitals.
html.description.abstractNCT02307669; Pre-results.


Files in this item

Thumbnail
Name:
e015367.full.pdf
Size:
625.6Kb
Format:
PDF
Description:
Main Article

This item appears in the following Collection(s)

Show simple item record