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

Sousa-Pinto B.;Louis R.;Anto J. M.;Amaral R.;Sa-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.;Puggioni F.;Regateiro F. S.;Romantowski J.;Sastre J.;Scichilone N.;Taborda-Barata L.;Ventura M. T.;Agache I.;Bedbrook A.;Becker S.;Bergmann K. C.;Bosnic-Anticevich S.;Bonini M.;Boulet L. -P.;Brusselle G.;Buhl R.;Cecchi L.;Charpin D.;de Blay F.;Del Giacco S.;Ivancevich J. C.;Jutel M.;Klimek L.;Kraxner H.;Kuna P.;Laune D.;Makela M.;Morais-Almeida M.;Nadif R.;Niedoszytko M.;Papadopoulos N. G.;Papi A.;Patella V.;Petre B.;Rivero Yeverino D.;Robalo Cordeiro C.;Roche N.;Rouadi P. W.;Samolinski B.;Savoure M.;Shamji M. H.;Sheikh A.;Suppli Ulrik C.;Usmani O. S.;Valiulis A.;Yorgancioglu A.;Zuberbier T.;Fonseca J. A.;Costa E. M.;Bousquet J.

2023-01-01

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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.