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. Puggioni; F. 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

doi:10.1016/j.pulmoe.2023.07.004

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 journal › Article › Research › peer-review

7 Citations (Scopus)

Abstract

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 language	English
Journal	Pulmonology
Early online date	3 Aug 2023
DOIs	https://doi.org/10.1016/j.pulmoe.2023.07.004
Publication status	E-pub ahead of print - 3 Aug 2023

Keywords

Adherence
Asthma
Formoterol
Inhaled corticosteroids
Long-acting-β2 agonist

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10.1016/j.pulmoe.2023.07.004

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Sousa-Pinto, B., Louis, R., Anto, J. M., Amaral, R., Sá-Sousa, A., Czarlewski, W., Brussino, L., Canonica, G. W., Chaves Loureiro, C., Cruz, A. A., Gemicioglu, B., Haahtela, T., Kupczyk, M., Kvedariene, V., Larenas-Linnemann, D. E., Okamoto, Y., Ollert, M., Pfaar, O., Pham-Thi, N., ... Bousquet, J. (2023). Adherence to inhaled corticosteroids and long-acting β2-agonists in asthma: A MASK-air study. Pulmonology. Advance online publication. https://doi.org/10.1016/j.pulmoe.2023.07.004

@article{845e08f2668049608b7729553b924829,

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

abstract = "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{\textregistered} 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{\textregistered} 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.",

keywords = "Adherence, Asthma, Formoterol, Inhaled corticosteroids, Long-acting-β2 agonist",

author = "B. Sousa-Pinto and R. Louis and Anto, {J. M.} and R. Amaral and A. S{\'a}-Sousa and W. Czarlewski and L. Brussino and Canonica, {G. W.} and {Chaves Loureiro}, C. and Cruz, {A. A.} and B. Gemicioglu and T. Haahtela and M. Kupczyk and V. Kvedariene and Larenas-Linnemann, {D. E.} and Y. Okamoto and M. Ollert and O. Pfaar and N. Pham-Thi and F. Puggioni and Regateiro, {F. S.} and J. Romantowski and J. Sastre and N. Scichilone and L. Taborda-Barata and Ventura, {M. T.} and I. Agache and A. Bedbrook and S. Becker and Bergmann, {K. C.} and S. Bosnic-Anticevich and M. Bonini and Boulet, {L. P.} and G. Brusselle and R. Buhl and L. Cecchi and D. Charpin and {de Blay}, F. and {Del Giacco}, S. and Ivancevich, {J. C.} and M. Jutel and L. Klimek and H. Kraxner and P. Kuna and D. Laune and M. Makela and M. Morais-Almeida and R. Nadif and M. Niedoszytko and Papadopoulos, {N. G.} and A. Papi and V. Patella and B. P{\'e}tr{\'e} and {Rivero Yeverino}, D. and {Robalo Cordeiro}, C. and N. Roche and Rouadi, {P. W.} and B. Samolinski and M. Savour{\'e} and Shamji, {M. H.} and A. Sheikh and {Suppli Ulrik}, C. and Usmani, {O. S.} and A. Valiulis and A. Yorgancioglu and T. Zuberbier and Fonseca, {J. A.} and Costa, {E. M.} and J. Bousquet",

note = "Funding Information: MASK-air{\textregistered} has been supported by EU grants (POLLAR, EIT Health; Structural and Development Funds, Twinning, EIP on AHA, H2020 and Horizon Europe) and by educational grants from Mylan-Viatris, ALK, GSK, Novartis and Uriach. There was no specific funding for this paper. Publisher Copyright: {\textcopyright} 2023 Sociedade Portuguesa de Pneumologia",

year = "2023",

month = aug,

day = "3",

doi = "10.1016/j.pulmoe.2023.07.004",

language = "English",

journal = "Pulmonology",

issn = "2531-0429",

publisher = "Elsevier Espana S.L.U",

}

Sousa-Pinto, B, Louis, R, Anto, JM, Amaral, R, Sá-Sousa, A, Czarlewski, W, Brussino, L, Canonica, GW, Chaves Loureiro, C, Cruz, AA, Gemicioglu, B, Haahtela, T, Kupczyk, M, Kvedariene, V, Larenas-Linnemann, DE, Okamoto, Y, Ollert, M, Pfaar, O, Pham-Thi, N, Puggioni, F, Regateiro, FS, Romantowski, J, Sastre, J, Scichilone, N, Taborda-Barata, L, Ventura, MT, Agache, I, Bedbrook, A, Becker, S, Bergmann, KC, Bosnic-Anticevich, S, Bonini, M, Boulet, LP, Brusselle, G, Buhl, R, Cecchi, L, Charpin, D, de Blay, F, Del Giacco, S, Ivancevich, JC, Jutel, M, Klimek, L, Kraxner, H, Kuna, P, Laune, D, Makela, M, Morais-Almeida, M, Nadif, R, Niedoszytko, M, Papadopoulos, NG, Papi, A, Patella, V, Pétré, B, Rivero Yeverino, D, Robalo Cordeiro, C, Roche, N, Rouadi, PW, Samolinski, B, Savouré, M, Shamji, MH, Sheikh, A, Suppli Ulrik, C, Usmani, OS, Valiulis, A, Yorgancioglu, A, Zuberbier, T, Fonseca, JA, Costa, EM & Bousquet, J 2023, 'Adherence to inhaled corticosteroids and long-acting β2-agonists in asthma: A MASK-air study', Pulmonology. https://doi.org/10.1016/j.pulmoe.2023.07.004

TY - JOUR

T1 - Adherence to inhaled corticosteroids and long-acting β2-agonists in asthma

T2 - A MASK-air study

AU - Sousa-Pinto, B.

AU - Louis, R.

AU - Anto, J. M.

AU - Amaral, R.

AU - Sá-Sousa, A.

AU - Czarlewski, W.

AU - Brussino, L.

AU - Canonica, G. W.

AU - Chaves Loureiro, C.

AU - Cruz, A. A.

AU - Gemicioglu, B.

AU - Haahtela, T.

AU - Kupczyk, M.

AU - Kvedariene, V.

AU - Larenas-Linnemann, D. E.

AU - Okamoto, Y.

AU - Ollert, M.

AU - Pfaar, O.

AU - Pham-Thi, N.

AU - Puggioni, F.

AU - Regateiro, F. S.

AU - Romantowski, J.

AU - Sastre, J.

AU - Scichilone, N.

AU - Taborda-Barata, L.

AU - Ventura, M. T.

AU - Agache, I.

AU - Bedbrook, A.

AU - Becker, S.

AU - Bergmann, K. C.

AU - Bosnic-Anticevich, S.

AU - Bonini, M.

AU - Boulet, L. P.

AU - Brusselle, G.

AU - Buhl, R.

AU - Cecchi, L.

AU - Charpin, D.

AU - de Blay, F.

AU - Del Giacco, S.

AU - Ivancevich, J. C.

AU - Jutel, M.

AU - Klimek, L.

AU - Kraxner, H.

AU - Kuna, P.

AU - Laune, D.

AU - Makela, M.

AU - Morais-Almeida, M.

AU - Nadif, R.

AU - Niedoszytko, M.

AU - Papadopoulos, N. G.

AU - Papi, A.

AU - Patella, V.

AU - Pétré, B.

AU - Rivero Yeverino, D.

AU - Robalo Cordeiro, C.

AU - Roche, N.

AU - Rouadi, P. W.

AU - Samolinski, B.

AU - Savouré, M.

AU - Shamji, M. H.

AU - Sheikh, A.

AU - Suppli Ulrik, C.

AU - Usmani, O. S.

AU - Valiulis, A.

AU - Yorgancioglu, A.

AU - Zuberbier, T.

AU - Fonseca, J. A.

AU - Costa, E. M.

AU - Bousquet, J.

N1 - Funding Information: MASK-air® has been supported by EU grants (POLLAR, EIT Health; Structural and Development Funds, Twinning, EIP on AHA, H2020 and Horizon Europe) and by educational grants from Mylan-Viatris, ALK, GSK, Novartis and Uriach. There was no specific funding for this paper. Publisher Copyright: © 2023 Sociedade Portuguesa de Pneumologia

PY - 2023/8/3

Y1 - 2023/8/3

N2 - 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.

AB - 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.

KW - Adherence

KW - Asthma

KW - Formoterol

KW - Inhaled corticosteroids

KW - Long-acting-β2 agonist

UR - http://www.scopus.com/inward/record.url?scp=85166957975&partnerID=8YFLogxK

UR - https://pubmed.ncbi.nlm.nih.gov/37543524

U2 - 10.1016/j.pulmoe.2023.07.004

DO - 10.1016/j.pulmoe.2023.07.004

M3 - Article

C2 - 37543524

AN - SCOPUS:85166957975

SN - 2531-0429

JO - Pulmonology

JF - Pulmonology

ER -

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

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