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Adherence rate to beclomethasone dipropionate and the level of asthma control
Authors:Jentzsch Nulma S  Camargos Paulo  Sarinho Emanuel S C  Bousquet Jean
Affiliation:a Department of Pediatrics and Postgraduate Institute, Medical Sciences School, Lucas Machado Foundation, Brazil
b Campos Sales Pediatric Pulmonology Outpatient Referral Clinic, Belo Horizonte Municipal Public Health Authority, Brazil
c Universidade Federal de São João del-Rei, Brazil
d Pediatric Pulmonology Unit, University Hospital, Federal University of Minas Gerais, Brazil
e Health Sciences, and Child and Adolescent Health Postgraduate Programs, Federal University of Pernambuco, Brazil
f Service des Maladies Respiratoires, Hôpital Arnaud de Villeneuve, France
Abstract:There are only a few studies assessing the relationship between adherence rate to ICS, as assessed by electronic monitoring, and the level of asthma control in childhood. The present study was carried out to examine the relationship between adherence to beclomethasone diproprionate (BDP) as well as other factors related to poor asthma control. In this prospective cohort study, 102 steroid na?ve randomly selected subjects with persistent asthma, aged 5-14 years were prescribed 500-750?μg daily of BDP-CFC and followed during one year. Adherence to BDP was measured electronically in the 4th, 8th and 12th months of study. The level of asthma control was classified as either controlled or uncontrolled instead of the current three categories recommended by the Global Initiative for Asthma (GINA). Mean adherence rate was higher in patients with controlled asthma during follow-up, but went down from 60.4% in the 4th month to 49.8% in the 12th month (p?=?0.038). Conversely, among patients with uncontrolled asthma, the mean adherence rate decreased from 43.8% to 31.2% (p?=?0.001). Multivariate analysis showed that the level of asthma control was independently associated to the adherence rate in all follow-up visits (p-values equal or lower than 0.005). The level of asthma control was directly proportional to adherence rate. Our results suggest that a BDP daily dose by 300?μg seems to be enough to attain control over mild and moderate persistent asthma, including exercise induced asthma.
Keywords:Adherence   Asthma control   Beclomethasone dipropionate   Electronic monitoring   Inhaled corticosteroids
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