Electronic medication monitoring versus self-reported use of inhaled corticosteroids and short-acting beta2-agonists in uncontrolled asthma | JoVE Visualize

Electronic medication monitoring versus self-reported use of inhaled corticosteroids and short-acting beta₂-agonists in uncontrolled asthma

Giselle S Mosnaim¹, David A Stempel², Candy Gonzalez³

¹Division of Pulmonary, Allergy and Critical Care, Department of Medicine, NorthShore University HealthSystem, Evanston, Illinois, USA.

The Journal of Asthma : Official Journal of the Association for the Care of Asthma|October 26, 2021

View abstract on PubMed

Summary

Patient self-reports overestimate inhaled corticosteroid (ICS) adherence. Electronic medication monitors (EMMs) provide objective data, revealing significant discrepancies in ICS use compared to self-reports.

Area of Science:

Pulmonary Medicine
Pharmacology
Medical Device Technology

Background:

Current methods for assessing inhaled corticosteroid (ICS) and short-acting beta 2-agonist (SABA) adherence, including patient self-report and clinician estimation, often overestimate actual medication usage.
Accurate adherence data is crucial for managing uncontrolled asthma and optimizing treatment outcomes.

Purpose of the Study:

To compare patient self-reported ICS and SABA use with objective adherence data obtained from electronic medication monitors (EMMs).
To evaluate the accuracy of standard self-report methods against objective measurements in asthma patients.

Main Methods:

Adults with uncontrolled asthma prescribed ICS and SABA were enrolled in the study.
Inhalers were fitted with EMMs to track real-time medication usage over 14 days.
Participants completed paper diaries for self-reported medication usage, which was then compared to EMM data using Wilcoxon signed-rank tests.

Main Results:

One hundred participants provided complete data; self-reported SABA use was higher than measured use, but not statistically significant (P=0.64).
Participant self-reported ICS adherence (median 97%) was significantly greater than objectively measured adherence (median 75%, P=0.002).
Significant discrepancies were observed between self-reported and objectively measured ICS usage.

Conclusions:

Patient self-reporting significantly overestimates ICS adherence in asthma management.
Electronic medication monitors (EMMs) offer a reliable method for clinicians to obtain accurate ICS medication-taking behavior data.
Utilizing EMMs can potentially simplify medication regimens, reduce side effects, and lower healthcare costs.