Asthma

26 October 2009

Difficult asthma, difficult patient

People with difficult-to-control asthma are often not taking their anti-asthma medication as prescribed by their doctor, new study findings indicate.

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People with difficult-to-control asthma are often not taking their anti-asthma medication as prescribed by their doctor, new study findings indicate.

Even when prescribed high doses of steroids, about 5% of adults with asthma remain difficult to control, with persistent symptoms and frequent flare-ups, Dr Liam G. Heaney at Queen's University of Belfast, Northern Ireland, and colleagues have found.

They thus remain at high risk for fatal or near-fatal asthma attacks. While not taking medication as prescribed is believed to contribute to this problem, its prevalence is unknown.

The study
To find out, Heaney's group studied 182 patients referred to the Northern Ireland Regional Difficult Asthma Service. Non-adherence to anti-asthma therapy was not suspected as a major issue, and all patients denied not taking their medicine at their first visit to the clinic.

Nonetheless, it was found that 35% of these patients had filled no more than half their prescriptions for inhaled steroids, and these patients were more likely to have been hospitalised at least 3 times in the previous year.

Women more lax
Women were most apt to be lax in taking their asthma controller medication as prescribed, the researchers note in the American Journal of Respiratory and Critical Care Medicine.

Among 51 asthma patients who were supposed to be using oral prednisolone, blood tests showed that 45% were non-adherent.

After being confronted about their prescription data, 88% admitted their poor compliance.

"One could speculate that if (patients) took regular preventative therapy (as prescribed) their asthma would probably improve substantially," Heaney and colleagues conclude. - (Reuters Health, October 2009)

SOURCE: American Journal of Respiratory and Critical Care Medicine, November 1, 2009.

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Professor Keertan Dheda has received of several prestigious awards including the 2014 Oppenheimer Award, and has published over 160 peer-reviewed papers and holds 3 patents related to new TB diagnostic or infection control technologies. He serves on the editorial board of the journals PLoS One, the International Journal of Tuberculosis and Lung Disease, American Journal of Respiratory and Critical Medicine, Lancet Respiratory Diseases and Nature Scientific Reports, amongst others.Read his full biography at the University of Cape Town Lung Institute

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