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 journalArticleResearchpeer-review

2 Citations (Scopus)


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
Early online date3 Aug 2023
Publication statusE-pub ahead of print - 3 Aug 2023


  • Adherence
  • Asthma
  • Formoterol
  • Inhaled corticosteroids
  • Long-acting-β2 agonist


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