Adherence to inhaled corticosteroids and long-acting β2-agonists in asthma: A MASK-air study

B Sousa-Pinto, R Louis, J M Anto, R Amaral, A Sá-Sousa, W Czarlewski, L Brussino, G W Canonica, C Chaves Loureiro, A A Cruz, B Gemicioglu, T Haahtela, M Kupczyk, V Kvedariene, D E Larenas-Linnemann, Y Okamoto, M Ollert, O Pfaar, N Pham-Thi, F PuggioniF S Regateiro, J Romantowski, J Sastre, N Scichilone, L Taborda-Barata, M T Ventura, I Agache, A Bedbrook, S Becker, K C Bergmann, S Bosnic-Anticevich, M Bonini, L-P Boulet, G Brusselle, R Buhl, L Cecchi, D Charpin, F de Blay, S Del Giacco, J C Ivancevich, M Jutel, L Klimek, H Kraxner, P Kuna, D Laune, M Makela, M Morais-Almeida, R Nadif, M Niedoszytko, N G Papadopoulos, A Papi, V Patella, B Pétré, D Rivero Yeverino, C Robalo Cordeiro, N Roche, P W Rouadi, B Samolinski, M Savouré, M H Shamji, A Sheikh, C Suppli Ulrik, O S Usmani, A Valiulis, A Yorgancioglu, T Zuberbier, J A Fonseca, E M Costa, J Bousquet*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract / Description of output

INTRODUCTION: Adherence to controller medication is a major problem in asthma management, being difficult to assess and tackle. mHealth apps can be used to assess adherence. We aimed to assess the adherence to inhaled corticosteroids+long-acting β2-agonists (ICS+LABA) in users of the MASK-air® app, comparing the adherence to ICS+formoterol (ICS+F) with that to ICS+other LABA.

MATERIALS AND METHODS: We analysed complete weeks of MASK-air® data (2015-2022; 27 countries) from patients with self-reported asthma and ICS+LABA use. We compared patients reporting ICS+F versus ICS+other LABA on adherence levels, symptoms and symptom-medication scores. We built regression models to assess whether adherence to ICS+LABA was associated with asthma control or short-acting beta-agonist (SABA) use. Sensitivity analyses were performed considering the weeks with no more than one missing day.

RESULTS: In 2598 ICS+LABA users, 621 (23.9%) reported 4824 complete weeks and 866 (33.3%) reported weeks with at most one missing day. Higher adherence (use of medication ≥80% of weekly days) was observed for ICS+other LABA (75.1%) when compared to ICS+F (59.3%), despite both groups displaying similar asthma control and work productivity. The ICS+other LABA group was associated with more days of SABA use than the ICS+F group (median=71.4% versus 57.1% days). Each additional weekly day of ICS+F use was associated with a 4.1% less risk in weekly SABA use (95%CI=-6.5;-1.6%;p=0.001). For ICS+other LABA, the percentage was 8.2 (95%CI=-11.6;-5.0%;p<0.001).

CONCLUSIONS: In asthma patients adherent to the MASK-air app, adherence to ICS+LABA was high. ICS+F users reported lower adherence but also a lower SABA use and a similar level of control.

Original languageEnglish
JournalPediatric Pulmonology
Early online date3 Aug 2023
DOIs
Publication statusE-pub ahead of print - 3 Aug 2023

Keywords / Materials (for Non-textual outputs)

  • Asthma
  • Adherence
  • Inhaled corticosteroids
  • Formoterol
  • Long-acting-b2 agonist

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