Corticosteroid use after hospital discharge among high-risk adults with asthma

American Journal of Respiratory and Critical Care Medicine
Jerry A KrishnanCynthia S Rand

Abstract

Despite the efficacy of corticosteroid therapy, patients hospitalized for asthma exacerbations are at high risk for re-exacerbation and death after discharge. The objective of this prospective cohort study was to evaluate adherence to inhaled corticosteroids (ICS) and oral corticosteroids (OCS) after discharge in adults hospitalized for asthma exacerbations. ICS and OCS were equipped with electronic medication monitors and were provided at discharge. Adherence (use/prescribed use x 100%) was measured by self-report and canister weight (ICS), pill count (OCS), and electronic medication monitors (both ICS and OCS) 2 weeks after discharge. Poor adherence was defined as adherence of less than 50%. The Asthma Control Questionnaire was used to assess symptom control. Sixty patients were enrolled (age 42.2 years, 98.3% African American, 65.0% female, 46.7% with history of near-fatal asthma). Electronically measured adherence to both corticosteroids dropped to approximately 50% within 7 days of discharge. Poor adherence to both corticosteroids predicted significantly worse symptom control (p = 0.04). Self-report, canister weight, and pill count all had low sensitivity (29.2%, 65.0%, and 7.7%, respectively) for detecting poor adherence....Continue Reading

References

May 1, 1991·Allergy Proceedings : the Official Journal of Regional and State Allergy Societies·G S FloraO P Sharma
Jul 1, 1986·New England and Regional Allergy Proceedings·M J ChandlerR Patterson
Nov 1, 1986·Thorax·H H ReaD C Sutherland
Aug 1, 1995·American Journal of Respiratory and Critical Care Medicine·C S RandJ Connett
Mar 1, 1997·Archives of Environmental Health·A H ChoudhuryS S Morris
Feb 25, 1998·Journal of Clinical Epidemiology·M McCarrenR J Rydman
Jun 25, 1998·American Journal of Respiratory and Critical Care Medicine·A J ApterR L ZuWallack
Oct 13, 1998·The Journal of Allergy and Clinical Immunology·M S SimmonsD P Tashkin
Nov 26, 1999·The European Respiratory Journal·E F JuniperD R King
May 5, 2000·The Cochrane Database of Systematic Reviews·B H RoweG W Bota
Aug 10, 2000·British Journal of Clinical Pharmacology·C F GeorgeC Thompson
Jan 10, 2001·The Journal of Allergy and Clinical Immunology·K B Weiss, S D Sullivan
May 2, 2001·The Cochrane Database of Systematic Reviews·B H RoweG W Bota
May 16, 2001·Annals of Internal Medicine·B J Turner, F M Hecht
Mar 13, 2002·Chest·Steven M JuliusLeslie Hendeles
Mar 30, 2002·BMJ : British Medical Journal·Rosalind M GreenAshley Woodcock
Apr 6, 2002·American Journal of Respiratory and Critical Care Medicine·Sarah A LewisDiane R Gold
Jul 23, 2002·JAMA : the Journal of the American Medical Association·Cynthia A JackeviciusJack V Tu
Apr 28, 2004·Diabetes Care·Joyce A Cramer
Aug 14, 2009·Proceedings of the American Thoracic Society·Susan M TarloUNKNOWN Third Jack Pepys Workshop on Asthma in the Workplace Participants

❮ Previous
Next ❯

Citations

Oct 3, 2008·Journal of General Internal Medicine·Andrea J ApterRima E Rudd
Aug 12, 2009·Annals of Allergy, Asthma & Immunology : Official Publication of the American College of Allergy, Asthma, & Immunology·Bruce Bender
Aug 12, 2009·Annals of Allergy, Asthma & Immunology : Official Publication of the American College of Allergy, Asthma, & Immunology·Edward M KerwinMitchell Goldman
Oct 23, 2008·Annals of Allergy, Asthma & Immunology : Official Publication of the American College of Allergy, Asthma, & Immunology·Bruce G BenderFrederick S Wamboldt
Oct 19, 2007·Annals of Allergy, Asthma & Immunology : Official Publication of the American College of Allergy, Asthma, & Immunology·Bruce G Bender
Nov 14, 2008·International Journal of Behavioral Medicine·Giselle S MosnaimLynda H Powell
Sep 26, 2009·Journal of Aerosol Medicine and Pulmonary Drug Delivery·Mathieu MolimardIsabelle Bourdeix
Nov 13, 2012·Current Opinion in Pulmonary Medicine·Kaharu Sumino, Michael D Cabana
Apr 18, 2009·Southern Medical Journal·Michael McDermott, Cathy Catrambone
Mar 5, 2010·Respirology : Official Journal of the Asian Pacific Society of Respirology·Robert J HancoxRichard Beasley
Sep 26, 2006·Journal of General Internal Medicine·Maureen GeorgeTerri E Weaver
Oct 31, 2006·Thorax·J M FitzGerald, P G Gibson
Aug 6, 2005·American Journal of Respiratory and Critical Care Medicine·Michael K Paasche-OrlowJerry A Krishnan
Jan 21, 2006·American Journal of Respiratory and Critical Care Medicine·Bruce G Bender
Jun 17, 2006·American Journal of Respiratory and Critical Care Medicine·Vidya KrishnanJerry A Krishnan
Jun 19, 2009·American Journal of Respiratory and Critical Care Medicine·Helen K ReddelUNKNOWN American Thoracic Society/European Respiratory Society Task Force on Asthma Control and Exacerbations
Aug 1, 2009·American Journal of Respiratory and Critical Care Medicine·Jacqueline GambleLiam G Heaney
Aug 31, 2010·American Journal of Respiratory and Critical Care Medicine·Francine M DucharmeXun Zhang
Mar 26, 2005·American Journal of Respiratory and Critical Care Medicine·Leonardo FabbriEdward Abraham
Sep 22, 2011·The European Respiratory Journal·K BlakeL Hendeles
Oct 28, 2009·CMAJ : Canadian Medical Association Journal = Journal De L'Association Medicale Canadienne·Rick HodderR Andrew McIvor
Jan 12, 2008·The British Journal of General Practice : the Journal of the Royal College of General Practitioners·Milind P SovaniTimothy W Harrison
Jun 16, 2012·Asia Pacific Allergy·Andrew Gillman, Jo A Douglass
May 8, 2014·Allergy and Asthma Proceedings·Kohei HasegawaCarlos A Camargo
Oct 14, 2009·Current Medical Research and Opinion·Prakash NavaratnamEduardo Urdaneta
Jan 29, 2014·Annals of Allergy, Asthma & Immunology : Official Publication of the American College of Allergy, Asthma, & Immunology·Giselle MosnaimLynda Powell
Feb 26, 2014·The Journal of Allergy and Clinical Immunology. in Practice·Giselle MosnaimLynda Powell
Feb 26, 2014·The Journal of Allergy and Clinical Immunology. in Practice·Andrew G Weinstein
Aug 30, 2012·Clinics in Chest Medicine·Louis-Philippe BouletJuliet M Foster
Mar 14, 2012·The Journal of Allergy and Clinical Immunology·Anne FuhlbriggeCarol Blaisdell
Mar 13, 2012·Revue des maladies respiratoires·M LubretI Tillie-Leblond
Nov 23, 2011·The Journal of Allergy and Clinical Immunology·Jerry A KrishnanUNKNOWN Adherence Ancillary Study Group
Apr 5, 2011·Annals of Allergy, Asthma & Immunology : Official Publication of the American College of Allergy, Asthma, & Immunology·Andrew G Weinstein
Mar 24, 2010·Annals of Allergy, Asthma & Immunology : Official Publication of the American College of Allergy, Asthma, & Immunology·John J Oppenheimer, Stephen P Peters
Aug 25, 2009·The Journal of Emergency Medicine·Jerry A KrishnanMichael Schatz
Mar 10, 2009·Journal of Pediatric Nursing·Anne M FitzpatrickW Gerald Teague
May 17, 2008·Heart & Lung : the Journal of Critical Care·Susan L JansonPaul D Blanc
Nov 27, 2007·La Presse médicale·Laurent LaforestEric Van Ganse
Nov 7, 2007·The Journal of Allergy and Clinical Immunology·Jerry A Krishnan, Michael Gould
Dec 15, 2015·The Journal of Allergy and Clinical Immunology·Paul M O'Byrne, Damian Tworek
Oct 2, 2007·The Journal of Allergy and Clinical Immunology·Belinda BorrelliLucille Rathier

❮ Previous
Next ❯

Related Concepts

Related Feeds

Allergy and Asthma

Allergy and asthma are inflammatory disorders that are triggered by the activation of an allergen-specific regulatory t cell. These t cells become activated when allergens are recognized by allergen-presenting cells. Here is the latest research on allergy and asthma.

Asthma

This feed focuses in Asthma in which your airways narrow and swell. This can make breathing difficult and trigger coughing, wheezing and shortness of breath.

American Thoracic Association Journals

Discover the latest respiratory research published by the journals from the American Thoracic Society.