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• W3022996443 abstract "Clinical Implications•Patients with asthma and chronic obstructive pulmonary disease are advised to closely adhere to their prescribed inhaler medication therapy due to the coronavirus disease 2019 pandemic. Using electronic medication data, we examined controller medication use and found positive increases in medication adherence. •Patients with asthma and chronic obstructive pulmonary disease are advised to closely adhere to their prescribed inhaler medication therapy due to the coronavirus disease 2019 pandemic. Using electronic medication data, we examined controller medication use and found positive increases in medication adherence. The appropriate use of adherence to daily controller medications is important for patients with respiratory illnesses during the coronavirus disease 2019 (COVID-19) pandemic.1Shaker M.S. Oppenheimer J. Grayson M. Stukus D. Hartog N. Hsieh E.W.Y. et al.COVID-19: pandemic contingency planning for the allergy and immunology clinic.J Allergy Clin Immunol Pract. 2020; 8: 1477-1488Abstract Full Text Full Text PDF PubMed Scopus (229) Google Scholar The recommended use of daily controller therapy for asthma and chronic obstructive pulmonary disease (COPD) has been associated with improved disease outcomes and decreased risk of respiratory exacerbations.1Shaker M.S. Oppenheimer J. Grayson M. Stukus D. Hartog N. Hsieh E.W.Y. et al.COVID-19: pandemic contingency planning for the allergy and immunology clinic.J Allergy Clin Immunol Pract. 2020; 8: 1477-1488Abstract Full Text Full Text PDF PubMed Scopus (229) Google Scholar, 2Bengtson L.G. DePietro M. McPheeters J. Fox K.M. Real-world outcomes in patients with chronic obstructive pulmonary disease initiating long-acting mono bronchodilator therapy.Ther Adv Respir Dis. 2018; 12 (1753466618772750)Crossref PubMed Scopus (5) Google Scholar, 3Engelkes M. Janssens H.M. de Jongste J.C. Sturkenboom M.C. Verhamme K.M. Medication adherence and the risk of severe asthma exacerbations: a systematic review.Eur Respir J. 2015; 45: 396-407Crossref PubMed Scopus (326) Google Scholar Increased adherence to daily medications is multifactorial and during the present pandemic may be driven by a patient's concern of his or her respiratory symptoms being associated or confused with COVID-19. Patients with well-managed symptoms are also less likely to seek acute respiratory care at health care facilities and emergency departments, which decreases the risk of incidental exposure to SARS-CoV-2 and allows health care providers to focus attention on patients with other critical needs.1Shaker M.S. Oppenheimer J. Grayson M. Stukus D. Hartog N. Hsieh E.W.Y. et al.COVID-19: pandemic contingency planning for the allergy and immunology clinic.J Allergy Clin Immunol Pract. 2020; 8: 1477-1488Abstract Full Text Full Text PDF PubMed Scopus (229) Google Scholar To understand how patients with asthma and COPD were responding to the recommendation of respiratory societies to follow daily medication regimens during the COVID-19 pandemic, we analyzed patient adherence to controller medication. Data were collected from Propeller Health (Madison, WI), a digital platform that tracks inhaler use through electronic medication monitors and sends alerts to patients for missed doses. This analysis was determined to be exempt by the Copernicus IRB (PRH1-18-132). We analyzed adherence to controller inhaler use for 7578 patients (77% asthma, 67% females) with a median (interquartile range) age of 40.0 (26.0-55.0) years. From the first 7 days of January 2020 to the last 7 days of March 2020, there was a 14.5% increase (53.7% to 61.5%) in mean daily controller medication adherence, previously defined4De Keyser H.E. Kaye L. Anderson W.C. Gondalia R. Theye B. Szefler S.J. et al.Electronic medication monitors help determine adherence subgroups in asthma.Resp Med. 2020; 164: 105914Abstract Full Text Full Text PDF PubMed Scopus (16) Google Scholar (Figure 1). We noted similar increases in adherence across age groups with older patients having higher levels of adherence. When adjusted for age, there were no clinically meaningful differences in adherence for patients with asthma or COPD. In addition, during the last week of March, over 53% of patients achieved ≥75% adherence to controller medications, a 14.9% increase from the first week of January. We have previously reported changes in adherence by month.5Kaye L. Hoch H. Szefler S.J. Anderson W. Barrett M. Van Sickle D. et al.Real-life patterns of asthma controller use vary by age, time of day and season.J Allergy Clin Immunol. 2018; 141: AB61Abstract Full Text Full Text PDF Google Scholar In children, 4-17 years of age, there is a peak noted in September-October that has been temporally associated with seasonal rhinovirus6Sears M.R. Johnston N.W. Understanding the September asthma epidemic.J Allergy Clin Immunol. 2007; 120: 526-529Abstract Full Text Full Text PDF PubMed Scopus (93) Google Scholar and in adults a peak noted in November-February with both age groups showing a decline in adherence in March and April.5Kaye L. Hoch H. Szefler S.J. Anderson W. Barrett M. Van Sickle D. et al.Real-life patterns of asthma controller use vary by age, time of day and season.J Allergy Clin Immunol. 2018; 141: AB61Abstract Full Text Full Text PDF Google Scholar Although we cannot definitively state the cause of the improvement in adherence, the trend may be reflective of patients responding to national COVID-19 guidelines7Centers for Disease Control and PreventionCoronavirus Disease 2019 (COVID-19) Situation Summary.https://www.cdc.gov/coronavirus/2019-ncov/index.htmlGoogle Scholar and to patient concern about controlling their primary respiratory illness with their controller medications. Furthermore, patients with asthma and COPD who track their adherence to their controller medications may be more motivated and achieve higher use of these medicines, and therefore the findings may not be generalizable to all patients.8Blakey J.D. Bender B.G. Dima A.L. Weinman J. Safioti G. Costello R.W. Digital technologies and adherence in respiratory diseases: the road ahead.Eur Respir J. 2018; 52: 1801147Crossref PubMed Scopus (78) Google Scholar Future analyses should also explore if medication adherence changed during other recent pandemics like H1N1. This initial evidence on adherence is encouraging during the first weeks of COVID-19 and hopefully will have a positive effect on improving control of asthma and COPD and minimize the need for acute care for their primary respiratory disease." @default.
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• W3022996443 title "Changes in medication adherence among patients with asthma and COPD during the COVID-19 pandemic" @default.
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