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Dose alerts help asthmatics breathe easier

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Asthmatics who receive personalised alerts are much more likely to take preventive medication and avoid severe asthma attacks, an Australian study has found.

In the first research of its kind, investigators at the Woolcock Institute of Medical Research have demonstrated that, over a six month period, asthmatics who received reminders took, on average, 73 per cent of the prescribed daily doses of corticosteroids, compared with less than half (46 per cent) among those who did not receive alerts.

Reflecting this higher compliance rate, only 11 per cent of patients who received reminders reported suffering a severe asthma flare up during the period, compared with 28 per cent of those who did not.

Study senior author, Associate Professor Helen Reddel, said the finding was significant because asthma was often poorly managed, leaving many sufferers vulnerable to potentially life-threatening attacks.

“Asthma is often poorly controlled because people are so busy and don’t remember t use their preventer inhalers,” A/Professor Reddel said. “Finding an easy and effective way to boost usage is a significant step forward.

For the research, published in The Journal of Allergy and Clinical Immunology, 43 GPs enrolled 143 patients aged between 14 and 65 years who had frequent asthma symptoms.

The patients were split into four groups. The first received alerts if they missed a dose and had online feedback about their usage, the second had personalised discussions with GPs about improving their compliance, the third received both alerts and had discussions with the GP and the fourth received active asthma care from their GP.

All patients used the electronic inhaler monitor system SmartTrack to record the date and time of dosages.

Overall, the study found that although medication compliance was much greater among patients who received alerts, there was no significant difference in the control of asthma symptoms among the four groups.

A/Professor Reddel said this was possibly because of the “quite high” doses of corticosteroids generally prescribed to asthma sufferers in Australia.

“The modest adherence in the non-reminder groups may have been enough to help control asthma symptoms, so the higher adherence rates in reminder groups could not produce any further improvements,” she said.

But A/Professor Reddel added that if compliance could be improved, there was an opportunity to reduce dosages.

Around two million people have asthma, which killed 394 in 2012 and caused almost 38,700 to be hospitalised. Effective management of the condition has been hampered by poor compliance with medication regimes.

A/Professor Reddel said the fact that those who received dosage alerts suffered half the proportion of flare ups as those who did not was “particularly significant” given that half the patients enrolled in the study lived in disadvantaged communities where medication compliance and the severity of attacks were likely to be worse.

She said longer-term studies were needed to investigate the effectiveness of dosage reminders for periods greater than six months.

Adrian Rollins