Effects of a structured educational intervention in moderate-to-severe elderly asthmatic subjects.

6533b82bfe1ef96bd128e154

RESEARCH PRODUCT

Effects of a structured educational intervention in moderate-to-severe elderly asthmatic subjects.

Nicola Scichilone Gabriella Guarnieri Amelia Grosso Ilaria Baiardini Pietro Pirina Antonio Molino Federica Albicini Vincenzo Patella Fulvio Braido Rita Raccanelli Andrea Vianello F. Di Marco G. Steinhilber Carolina Lombardi Mariangiola Crivellaro Erminia Ridolo Alida Benfante Erica Gini Manlio Milanese R. De Tullio Mario Polverino Maria Teresa Costantino Angelo Corsico Giovanni Rolla Marcello Cottini Silvia Terraneo Marco Caminati

subject

Vital capacity ACT asthma control test Exacerbation SAE severe asthma exacerbation SF12 chlorofluorocarbons mental health composite score EDUCA elderly and device use in chronic asthma PCS physical health composite score ACT asthma control test; AHDS hospital anxiety depression scale; Asthma; CFC chlorofluorocarbons; Device misuse; EDUCA elderly and device use in chronic asthma; Education; Elderly; FEV1 forced expiratory volume 1s second; FVC forced vital capacity; ICS inhaled corticosteroids; LABA long-acting β2 agonist; LAMA long-acting muscarinic antagonists; MCS mental health composite score; PCS physical health composite score; PROs patient-reported outcomes; SAE severe asthma exacerbation; SF12 short form health survey; mMRC modified medical research council EDUCA FEV1 0302 clinical medicine Elderly Immunology and Allergy Medicine 030223 otorhinolaryngology biology mMRC modified medical research council severe asthma exacerbation modified medical research council LAMA SAE Lama elderly and device use in chronic asthma Metered-dose inhaler Dry-powder inhaler Device misuse PROs patient-reported outcomes CFC PCS patient-reported outcomes mMRC lcsh:Immunologic diseases. Allergy Pulmonary and Respiratory Medicine long-acting β2 agonist medicine.medical_specialty Immunology LABA physical health composite score Article LAMA long-acting muscarinic antagonists AHDS Education 03 medical and health sciences FEV1/FVC ratio long-acting muscarinic antagonists forced vital capacity SF12 short form health survey Asthma; Device misuse; Education; Elderly Internal medicine MCS mental health composite score forced expiratory volume 1s second Asthma business.industry FEV1 forced expiratory volume 1s second Inhaler asthma control test biology.organism_classification medicine.disease CFC chlorofluorocarbons ACT ICS inhaled corticosteroids FVC Asthma MCS hospital anxiety depression scale 030228 respiratory system ICS AHDS hospital anxiety depression scale FVC forced vital capacity PROs short form health survey inhaled corticosteroids lcsh:RC581-607 business LABA long-acting β2 agonist

description

Background: Adherence to inhaled drugs is linked to patients’ satisfaction with their device, and an incorrect use can negatively affect the outcomes of asthma treatment. We speculated that this is particularly true in elderly asthmatic subjects. Aim: We performed a national pre-post interventional multicentre study, enrolling moderate-to-severe asthmatic subjects aged ≥65 years treated with fixed inhaled combination drugs by dry powder inhaler (DPI) or pressurized metered dose inhaler (pMDI). Adherence and critical errors were evaluated by means of validated questionnaires at first visit (V1) and after 3–6 months (V2). At V1, subjects underwent intensive training on the correct use of their device by physical demonstration. Results: A total of 411 asthmatics (F/M: 238/173, mean age±SD: 72 ± 5 years) participated to the study. At V1, 50% of the study subjects showed an Asthma Control Test (ACT) score ≤19 despite GINA step 3 and 4 treatment, and 40% had experienced at least one severe asthma exacerbation in the previous year. Poor adherence to treatment was recorded in 43% of subjects, and at least one error in using the device was registered in 56% of subjects. At V2, available for 318 patients, both the percentage of individuals with poor adherence and with at least one critical error significantly decreased (from 46% to 25%, and from 49% to 25%, respectively; p < 0.001 for both comparisons) with a significant increase of the ACT score (from 19 ± 4.9 to 20 ± 4.0, p < 0.001). Conclusions: Asthma in the elderly is characterized by low levels of symptom control. Educational interventions are strongly advocated in this age group in order to increase adherence to treatment and inhaler techniques. Keywords: Elderly, Asthma, Device misuse, Education

year	journal	country	edition	language
2019-01-24	The World Allergy Organization journal

10.1016/j.waojou.2019.100040 https://pubmed.ncbi.nlm.nih.gov/31316712