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• W3008976267 abstract "Objective To assess the association between adherence levels and severe asthma exacerbation. Design A systematic search was performed from inception to November 2018 on the following databases: PubMed, CENTRAL, EMBASE, and ClinicalTrials.gov. Setting and participants Randomized-controlled trials (RCTs) and cohort and case-control studies that investigated the impact of adherence to controller medications on severe asthma exacerbation were included in the analysis. Data extraction was undertaken by 2 reviewers, and all studies were assessed for their qualities using the Cochrane risk of bias tool for RCT and the Newcastle-Ottawa scale for cohort and case-control studies. Random-effects model meta-analyses were performed. Outcome measures Severe asthma exacerbation. Results From 8061 articles, 8 studies were included in quantitative synthesis. The meta-analyses revealed that the odds of exacerbation among the patients with 80% or more adherence were lowered by 47% (odds ratio 0.53 [95% CI 0.42–0.66], P < 0.001) compared with less than 80%. When compared with less than 20% adherence, a 33% reduction in the odds (0.67 [0.53–0.86], P = 0.001) was associated with the patients achieving 50% or more, whereas a decrease in exacerbation was not associated with 20% to 49% adherence (0.94 [0.85–1.04], P = 0.22). In addition, a 2.4-fold increase in the odds (2.4 [2.1–2.7], P < 0.001) was associated with discontinuation of therapy. Conclusion The highest reduction in the odds of exacerbation was associated with patients achieving 80% or more adherence, and the odds also reduced among those with 50% or more adherence, whereas a substantial increase in exacerbation was associated with discontinuation of therapy." @default.
• W3008976267 created "2020-03-06" @default.
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• W3008976267 date "2020-09-01" @default.
• W3008976267 modified "2023-10-18" @default.
• W3008976267 title "Association between adherence and severe asthma exacerbation: A systematic review and meta-analysis" @default.
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• W3008976267 doi "https://doi.org/10.1016/j.japh.2020.02.010" @default.
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