1. Effects of a structured educational intervention in moderate-to-severe elderly asthmatic subjects
- Author
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Nicola Scichilone, Gabriella Guarnieri, Amelia Grosso, Ilaria Baiardini, Pietro Pirina, Antonio Molino, Federica Albicini, Vincenzo Patella, Fulvio Braido, Rita Raccanelli, Andrea Vianello, F. Di Marco, G. Steinhilber, Carolina Lombardi, Mariangiola Crivellaro, Erminia Ridolo, Alida Benfante, Erica Gini, Manlio Milanese, R. De Tullio, Mario Polverino, Maria Teresa Costantino, Angelo Corsico, Giovanni Rolla, Marcello Cottini, Silvia Terraneo, Marco Caminati, Milanese, M., Terraneo, S., Baiardini, I., Di Marco, F., Corsico, A., Molino, A., Scichilone, N., Albicini, F., Benfante, A., Braido, F., Caminati, M., Costantino, M. T., Cottini, M., Crivellaro, M., De Tullio, R., Gini, E., Grosso, A., Guarnieri, G., Lombardi, C., Patella, V., Pirina, P., Polverino, M., Raccanelli, R., Ridolo, E., Rolla, G., Steinhilber, G., Vianello, A., Milanese M., Terraneo S., Baiardini I., Di Marco F., Corsico A., Molino A., Scichilone N., Albicini F., Benfante A., Braido F., Caminati M., Costantino M.T., Cottini M., Crivellaro M., De Tullio R., Gini E., Grosso A., Guarnieri G., Lombardi C., Patella V., Pirina P., Polverino M., Raccanelli R., Ridolo E., Rolla G., Steinhilber G., and Vianello A.
- Subjects
Vital capacity ,ACT, asthma control test ,Exacerbation ,SAE, severe asthma exacerbation ,SF12 ,chlorofluorocarbons ,mental health composite score ,EDUCA, elderly and device use in chronic asthma ,PCS, physical health composite score ,AHDS, hospital anxiety depression scale ,Asthma ,CFC, chlorofluorocarbons ,Device misuse ,Education ,Elderly ,FEV1, forced expiratory volume 1s second ,FVC, forced vital capacity ,ICS, inhaled corticosteroids ,LABA, long-acting β2 agonist ,LAMA, long-acting muscarinic antagonists ,MCS, mental health composite score ,PROs, patient-reported outcomes ,SF12, short form health survey ,mMRC, modified medical research council ,EDUCA ,FEV1 ,0302 clinical medicine ,Immunology and Allergy ,Medicine ,030223 otorhinolaryngology ,biology ,severe asthma exacerbation ,modified medical research council ,LAMA ,SAE ,Lama ,elderly and device use in chronic asthma ,Metered-dose inhaler ,Dry-powder inhaler ,CFC ,PCS ,patient-reported outcomes ,mMRC ,lcsh:Immunologic diseases. Allergy ,Pulmonary and Respiratory Medicine ,long-acting β2 agonist ,medicine.medical_specialty ,Immunology ,LABA ,physical health composite score ,Article ,AHDS ,03 medical and health sciences ,FEV1/FVC ratio ,long-acting muscarinic antagonists ,forced vital capacity ,Internal medicine ,forced expiratory volume 1s second ,business.industry ,Inhaler ,asthma control test ,biology.organism_classification ,medicine.disease ,ACT ,FVC ,MCS ,hospital anxiety depression scale ,030228 respiratory system ,ICS ,PROs ,short form health survey ,inhaled corticosteroids ,lcsh:RC581-607 ,business - Abstract
Background: Adherence to inhaled drugs is linked to patients’ satisfaction with their device, and an incorrect use can negatively affect the outcomes of asthma treatment. We speculated that this is particularly true in elderly asthmatic subjects. Aim: We performed a national pre-post interventional multicentre study, enrolling moderate-to-severe asthmatic subjects aged ≥65 years treated with fixed inhaled combination drugs by dry powder inhaler (DPI) or pressurized metered dose inhaler (pMDI). Adherence and critical errors were evaluated by means of validated questionnaires at first visit (V1) and after 3–6 months (V2). At V1, subjects underwent intensive training on the correct use of their device by physical demonstration. Results: A total of 411 asthmatics (F/M: 238/173, mean age±SD: 72 ± 5 years) participated to the study. At V1, 50% of the study subjects showed an Asthma Control Test (ACT) score ≤19 despite GINA step 3 and 4 treatment, and 40% had experienced at least one severe asthma exacerbation in the previous year. Poor adherence to treatment was recorded in 43% of subjects, and at least one error in using the device was registered in 56% of subjects. At V2, available for 318 patients, both the percentage of individuals with poor adherence and with at least one critical error significantly decreased (from 46% to 25%, and from 49% to 25%, respectively; p
- Published
- 2019