Klin Farmakol Farm. 2024;38(1):31-37 | DOI: 10.36290/far.2024.005

Effective interventions to increase adherence to inhaled therapy in patients with bronchial asthma - a review article

Karolína Nálevková1, Tereza Hendrychová1, Vladimír Koblížek2, Vratislav Sedlák2, Josef Malý1
1 Katedra sociální a klinické farmacie, Farmaceutická fakulta UK v Hradci Králové
2 Plicní klinika, Fakultní nemocnice Hradec Králové

Bronchial asthma, a chronic pulmonary disease, has a major impact on the patient's daily life. Medication adherence and correct inhalation technique are essential to achieve the goals of therapy. The aim of this paper is to provide a review of published literature evaluating the effect of pharmacist-led interventions on medication adherence or inhalation technique in adult patients with bronchial asthma. A total of 23 studies were identified by a literature search of PubMed and Scopus databases. The analysis of the selected studies suggested that pharmacist-led intervention in any form had a positive impact on both above mentioned oberved phenomena and clinical outcomes of bronchial asthma therapy and can significantly contribute to improvement of patients´ quality of life.

Keywords: bronchial asthma, medication adherence, inhalation technique, pharmacist, intervention.

Accepted: March 26, 2024; Published: April 8, 2024  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
Nálevková K, Hendrychová T, Koblížek V, Sedlák V, Malý J. Effective interventions to increase adherence to inhaled therapy in patients with bronchial asthma - a review article. Klin Farmakol Farm. 2024;38(1):31-37. doi: 10.36290/far.2024.005.
Download citation

References

  1. WHO. Asthma. [Internet]. 2023. [cited 2023 May 17]. Available from: https://www.who.int/news-room/fact-sheets/detail/asthma.
  2. Engelkes M, Janssens HM, de Jongste JC, et al. Medication adherence and the risk of severe asthma exacerbations: a systematic review. Eur Respir J. 2015;45(2):396-407. Go to original source... Go to PubMed...
  3. WHO. Adherence to long-term therapies: evidence for action. [Internet]. 2003. [cited 2023 Aug 16]. Available from: Adh.200x260/0 (who.int).
  4. Usmani OS, Lavorini F, Marshall J, et al. Critical inhaler errors in asthma and COPD: a systematic review of impact on health outcomes. Respir Res. 2018;19(1):10. Go to original source... Go to PubMed...
  5. Global Initiative for Asthma. Global Strategy for Asthma Management and Prevention, 2022. [Internet]. 2022. GINA. [cited 2023 Aug 16]. Available from: GINA Main Report 2022 Front Cover (ginasthma.org).
  6. Plaza V, Giner J, Rodrigo GJ, et al. Errors in the use of inhalers by health care professionals: A systematic review. J Aller Cl Imm-Pract. 2018;6(3):987-995. Go to original source... Go to PubMed...
  7. Usmani OS. Choosing the right inhaler for your asthma or COPD patient. Ther Clin Risk Manag. 2019;15:461-472. Go to original source... Go to PubMed...
  8. Khdour MR, Elyan SO, Hallak HO, et al. Pharmaceutical care for adult asthma patients: A controlled intervention one-year follow-up study. Basic Clin Pharmacol Toxicol. 2020; 126(4):332-340. Go to original source... Go to PubMed...
  9. Armour CL, Reddel HK, LeMay KS, et al. Feasibility and effectiveness of an evidence-based asthma service in Australian community pharmacies: a pragmatic cluster randomized trial. J Asthma. 2013;50(3):302-309. Go to original source... Go to PubMed...
  10. Paoletti G, Keber E, Heffler E, et al. Effect of an educational intervention delivered by pharmacists on adherence to treatment, disease control and lung function in patients with asthma. Respir Med. 2020;174:106199. Go to original source... Go to PubMed...
  11. Morisky DE, Green LW, Levine DM. Concurrent and predictive validity of a self-reported measure of medication adherence. Med Care. 1986;24(1):67-74. Go to original source... Go to PubMed...
  12. Morisky DE, Ang A, Krousel-Wood M, et al. Predictive validity of a medication adherence measure in an outpatient setting. J Clin Hypertens (Greenwich). 2008;10(5):348-354. ("retracted article") Go to original source... Go to PubMed...
  13. Horne R, Weinman J. Self-regulation and self-management in asthma: exploring the role of illness perceptions and treatment beliefs in explaining non-adherence to preventer medication. Psychology & Health. 2002;17(1):17-32. Go to original source...
  14. Plaza V, Fernández-Rodríguez C, Melero C. Validation of the 'Test of the Adherence to Inhalers' (TAI) for Asthma and COPD Patients. J Aerosol Med Pulm Drug Deliv. 2016;29(2):142-152. Go to original source... Go to PubMed...
  15. Nathan RA, Sorkness CA, Kosinski M, et al. Development of the asthma control test: a survey for assessing asthma control. J Allergy Clin Immunol. 2004;113(1):59-65. Go to original source... Go to PubMed...
  16. Juniper EF, O'Byrne PM, Guyatt GH, et al. Development and validation of a questionnaire to measure asthma control. Eur Respir J, 1999;14(4):902-907. Go to original source... Go to PubMed...
  17. Katz PP, Yelin EH, Smith S, et al. Perceived control of asthma: development and validation of a questionnaire. Am J Respir Crit Care Med. 1997;155(2):577-582. Go to original source... Go to PubMed...
  18. Manfrin A, Tinelli M, Thomas T, et al. A cluster randomised control trial to evaluate the effectiveness and cost-effectiveness of the Italian medicines use review (I-MUR) for asthma patients. BMC Health Serv Res. 2017;17(1):300. Go to original source... Go to PubMed...
  19. Nonhlanhla NP, Schellack N, Gous A. What difference can pharmacist-driven management of adult patients with chronic persistent asthma make at a tertiary Academic Hospital in Gauteng, South Africa? Eur J Clin Pharm. 2017;19(2):112-124.
  20. Juniper EF, Buist AS, Cox FM, et al. Validation of a standardized version of the Asthma Quality of Life Questionnaire. Chest. 1999;115(5):1265-1270. Go to original source... Go to PubMed...
  21. Marks GB, Dunn SM, Woolcock AJ. A scale for the measurement of quality of life in adults with asthma. J Clin Epidemiol. 1992;45(5):461-472. Go to original source... Go to PubMed...
  22. Cohen RD. Validation of health-related quality of life instruments. Hepatology. 1999;29(6):7S-8S.
  23. Mehuys E, Van Bortel L, De Bolle L, et al. Effectiveness of pharmacist intervention for asthma control improvement. Eur Respir J. 2008;31(4):790-799. Go to original source... Go to PubMed...
  24. Wang KY, Chian CF, Lai HR, et al. Clinical pharmacist counseling improves outcomes for Taiwanese asthma patients. Pharm World Sci. 2010;32(6):721-729. Go to original source... Go to PubMed...
  25. Torres-Robles A, Benrimoj SI, Gastelurrutia MA, et al. Effectiveness of a medication adherence management intervention in a community pharmacy setting: a cluster randomised controlled trial. BMJ Qual Saf. 2022;31(2):105-115. Go to original source... Go to PubMed...
  26. Giraud V, Allaert FA, Roche N. Inhaler technique and asthma: feasability and acceptability of training by pharmacists. Respir Med. 2011;105(12):1815-1822. Go to original source... Go to PubMed...
  27. Wong LY, Chua SS, Husin AR, et al. A pharmacy management service for adults with asthma: a cluster randomised controlled trial. Fam Pract. 2017;34(5):564-573. Go to original source... Go to PubMed...
  28. Rodrigues AT, Romano S, Romão M, et al. Effectiveness of a pharmacist-led intervention on inhalation technique for asthma and COPD patients: The INSPIRA pilot cluster-randomized controlled trial. Respir Med. 2021;185:106507. Go to original source... Go to PubMed...
  29. Weinberger M, Murray MD, Marrero DG, et al. Effectiveness of pharmacist care for patients with reactive airways disease: a randomized controlled trial. JAMA. 2002;288(13):1594-1602. Go to original source... Go to PubMed...
  30. Stiegler KA, Yunker NS, Crouch MA. Effect of pharmacist counseling in patients hospitalized with acute exacerbation of asthma. Am J Health Syst Pharm. 2003;60(5):473-476. Go to original source... Go to PubMed...
  31. Armour C, Bosnic-Anticevich S, Brillant M et al. Pharmacy Asthma Care Program (PACP) improves outcomes for patients in the community. Thorax. 2007;62(6):496-502. Go to original source... Go to PubMed...
  32. Garcia-Cardenas V, Sabater-Hernandez D, Kenny P, et al. Effect of a pharmacist intervention on asthma control. A cluster randomised trial. Resp Med. 2013;107(9):1346-1355. Go to original source... Go to PubMed...
  33. Smith L, Bosnic-Anticevich SZ, Mitchell B, et al. Treating asthma with a self-management model of illness behaviour in an Australian community pharmacy setting. Soc Sci Med. 2007;64(7):1501-1511. Go to original source... Go to PubMed...
  34. Abdelhamid E, Awad A, Gismallah A. Evaluation of a hospital pharmacy-based pharmaceutical care services for asthma patients. Pharm Pract (Granada). 2008;6(1):25-32. Go to original source... Go to PubMed...
  35. Kuipers E, Wensing M, de Smet P, et al. Self-management research of asthma and good drug use (SMARAGD study): a pilot trial. Int J Clin Pharm. 2017;39(4):888-896. Go to original source... Go to PubMed...
  36. Serhal S, Saini B, Bosnic-Anticevich S, et al. A Targeted Approach to Improve Asthma Control Using Community Pharmacists. Front Pharmacol. 2021;12:798263. Go to original source... Go to PubMed...
  37. Al-Qudah RA, Bulatova RB, Obeidat NM, et al. Impact of home medication management review on medication adherence among Jordanian patients. J Pharm Health Serv Res. 2018;9(3):227-235. Go to original source...
  38. Alnawayseh T, Naddaf A, Taybeh E. The impact of the clinical pharmacist on the use of inhalers among asthmatic patients in Alkarak region in the South of Jordan. J Pharm Health Serv Res. 2020;11(2):167-172. Go to original source...
  39. Young HN, Havican SN, Griesbach S, et al. Patient and phaRmacist telephonic encounters (PARTE) in an underserved rural patient population with asthma: results of a pilot study. Telemed J E Health. 2012;18(6):427-433. Go to original source... Go to PubMed...
  40. Sari CP, Hakim L, Putu ID. Role of pharmacist in counseling asthma to improve patient adherence in Yogyakarta. Asian J Pharm Clin Res. 2017;10(14):16-20. Go to original source...
  41. Mahdavi H, Esmaily H. Impact of educational intervention by community pharmacists on asthma clinical outcomes, quality of life and medication adherence: A systematic review and meta-analysis. J Clin Pharm Ther. 2021;46(5):1254-1262. Go to original source... Go to PubMed...
  42. Mes MA, Katzer CB, Chan AHY, et al. Pharmacists and medication adherence in asthma: a systematic review and meta-analysis. Eur Respir J. 2018;52(2):1800485. Go to original source... Go to PubMed...
  43. Dokbua S, Dilokthornsakul P, Chaiyakunapruk N, et al. Effects of an Asthma Self-Management Support Service Provided by Community Pharmacists: A Systematic Review and Meta-Analysis. J Manag Care Spec Pharm. 2018;24(11):1184-1196. Go to original source... Go to PubMed...
  44. Garcia-Cardenas V, Armour C, Benrimoj SI, et al. Pharmacists' interventions on clinical asthma outcomes: a systematic review. Eur Respir J. 2016;47(4):1134-1143. Go to original source... Go to PubMed...
  45. Klijn SL, Hiligsmann M, Evers SMAA, et al. Effectiveness and success factors of educational inhaler technique interventions in asthma & COPD patients: a systematic review. NPJ Prim Care Respir Med. 2017;27(1):24. Go to original source... Go to PubMed...
  46. Milosavljevic A, Aspden T, Harrison J. Community pharmacist-led interventions and their impact on patients' medication adherence and other health outcomes: a systematic review. Int J Pharm Pract. 2018;26(5):387-397. Go to original source... Go to PubMed...
  47. Jia X, Zhou S, Luo D, et al. Effect of pharmacist-led interventions on medication adherence and inhalation technique in adult patients with asthma or COPD: A systematic review and meta-analysis. J Clin Pharm Ther. 2020;45(5):904-917. Go to original source... Go to PubMed...
  48. Jeminiwa R, Hohmann L, Qian J, et al. Impact of eHealth on medication adherence among patients with asthma: A systematic review and meta-analysis. Respir Med. 2019;149:59-68. Go to original source... Go to PubMed...
  49. Shah RF, Gupta RM. Video instruction is more effective than written instruction in improving inhaler technique. Pulm Pharmacol Ther. 2017;46:16-19. Go to original source... Go to PubMed...
  50. Schulte MHJ, Aardoom JJ, Loheide-Niesmann L, et al. Effectiveness of eHealth Interventions in Improving Medication Adherence for Patients With Chronic Obstructive Pulmonary Disease or Asthma: Systematic Review. J Med Internet Res. 2021;23(7):e29475. Go to original source... Go to PubMed...
  51. Vytrisalova M, Hendrychova T, Touskova T, et al. Breathing Out Completely Before Inhalation: The Most Problematic Step in Application Technique in Patients With Non-Mild Chronic Obstructive Pulmonary Disease. Front Pharmacol. 2019;10:241. Go to original source... Go to PubMed...
  52. Ladova K, Vlcek J, Vytrisalova M, et al. Healthy adherer effect - the pitfall in the interpretation of the effect of medication adherence on health outcomes. J Eval Clin Pract. 2014;20(2):111-116. Go to original source... Go to PubMed...
  53. Press VG, Arora VM, Trela KC, et al. Effectiveness of Interventions to Teach Metered-Dose and Diskus Inhaler Techniques. A Randomized Trial. Ann Am Thorac Soc. 2016;13(6):816-824. Go to original source... Go to PubMed...
  54. Howell G. Nonadherence to medical therapy in asthma: risk factors, barriers, and strategies for improving. J Asthma. 2008;45(9):723-729. Go to original source... Go to PubMed...
  55. Krigsman K, Nilsson JL, Ring L. Adherence to multiple drug therapies: refill adherence to concomitant use of diabetes and asthma/COPD medication. Pharmacoepidemiol Drug Saf. 2007;16(10):1120-1128. Go to original source... Go to PubMed...
  56. Hämmerlein A, Müller U, Schulz M. Pharmacist-led intervention study to improve inhalation technique in asthma and COPD patients. J Eval Clin Pract. 2011;17(1):61-70. Go to original source... Go to PubMed...
  57. Cochrane MG, Bala MV, Downs KE, et al. Inhaled corticosteroids for asthma therapy: patient compliance, devices, and inhalation technique. Chest. 2000;117(2):542-550. Go to original source... Go to PubMed...
  58. Lavorini F, Magnan A, Dubus JC, et al. Effect of incorrect use of dry powder inhalers on management of patients with asthma and COPD. Respir Med. 2008;102(4):593-604. Go to original source... Go to PubMed...
  59. Mala-Ladova K, Voriskova E, Kostalova B, et al. Terminologie adherence k lecbe - prvotni konsenzualni preklad pomoci Delphi metody. Vnitr Lek. 2022;68(2):22-28. Go to original source...
  60. Vrijens B, Dima AL, Van Ganse E, et al. What we mean when we talk about adherence in respiratory medicine. J Aller Cl Imm-Pract. 2016;4(5):802-812. Go to original source... Go to PubMed...




Clinical Pharmacology and Pharmacy

Madam, Sir,
please be aware that the website on which you intend to enter, not the general public because it contains technical information about medicines, including advertisements relating to medicinal products. This information and communication professionals are solely under §2 of the Act n.40/1995 Coll. Is active persons authorized to prescribe or supply (hereinafter expert).
Take note that if you are not an expert, you run the risk of danger to their health or the health of other persons, if you the obtained information improperly understood or interpreted, and especially advertising which may be part of this site, or whether you used it for self-diagnosis or medical treatment, whether in relation to each other in person or in relation to others.

I declare:

  1. that I have met the above instruction
  2. I'm an expert within the meaning of the Act n.40/1995 Coll. the regulation of advertising, as amended, and I am aware of the risks that would be a person other than the expert input to these sites exhibited


No

Yes

If your statement is not true, please be aware
that brings the risk of danger to their health or the health of others.