Open AccessMetered dose inhaler technique among inner‐city asthmatics and its association with asthma medication adherence
Author(s) -
Lurslurchachai Linda,
Krauskopf Katherine,
Roy Angkana,
Halm Ethan A.,
Leventhal Howard,
Wisnivesky Juan P.
Publication year - 2014
Publication title -
the clinical respiratory journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.789
H-Index - 33
eISSN - 1752-699X
pISSN - 1752-6981
DOI - 10.1111/crj.12084
Subject(s) - medicine , asthma , metered dose inhaler , checklist , inhaler , asthma medication , medication adherence , cohort , prospective cohort study , psychology , cognitive psychology
Abstract Introduction Inhaled medications, critical for asthma treatment, are self‐administered through metered dose inhalers ( MDI ). Asthma self‐management hinges on adherence to these medications and to proper MDI technique. Objective To assess predictors of proper MDI technique, and MDI technique as a tool to identify patients with low adherence to inhaled medications. Methods Prospective cohort of asthmatics from clinics in N ew Y ork, NY and N ew B runswick, NJ . MDI technique was assessed using a standardized checklist. Adherence to inhaled asthma controller medication was evaluated with the M edication A dherence R eport S cale. Predictors of MDI technique were evaluated using regression analyses. The distribution of number of MDI technique steps missed was compared in adherent vs. non‐adherent asthmatics. Results Overall, 326 patients were included (55% Hispanic, 27% Black). In adjusted analyses, age < 55 years was significantly associated with MDI technique ( P = 0.03). Overall, 12%, 34%, 40% of asthmatics missed 5–6, 3–4, or 1–2 MDI steps; 16% received a perfect MDI technique score. Adherence rates were 20%, 39%, 48%, and 62% among those who missed 5–6, 3–4, 1–2, or none of the steps in the MDI technique checklist ( P < 0.001). Conclusion Poor MDI technique is common among inner‐city patients with asthma and is associated with poor adherence to controller medications. Older patients with asthma are at higher risk of improper MDI technique. Assessment of MDI technique may be a simple clinical aid to identify patients with low adherence to controller medications.