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Adherence Barriers and Dulera Adherence in an Asthma Adherence Management Study: Preliminary Results
Sunday, March 6, 2016: 2:00 PM
Theatre, Room 411 (Convention Center)
Andrew G. Weinstein, MD FAAAAI, , , ,
Rationale: Medication adherence for persistent adult asthma patients is estimated to be 50%.

Methods: 7 of 20 intervention subjects completed an ongoing 3 month prospective nested study of the Asthma Adherence Pathway App, an asthma adherence management program.  Intervention Subjects completed the AsthmaAdherence Pathway App (AAPApp), at entry and follow-up, which identified frequency of asthma symptoms and subject barriers to adherence. Barrier domains: Attitudes about care; QoL; Patient support; Medical concerns; Medication preference; Cost; and Psychological concerns. Subject Adherence (SA) was measured by the Smart Inhaler and dose counter and determined by the mean of 4 subject adherence measures during the 3 month study. Intervention investigators were trained in patient-centered communication skills -Motivational Interviewing to optimize delivery of adherence strategies. Dulera dosing for Intervention Subjects was similar to Control subjects who were not monitored for adherence and did not complete the survey. 

Results: Mean SA 77%. Primary Barriers (Initial number of subjects versus Follow-up): Psychological (4 versus 3); QoL (3 versus 2); Medical concerns (3 versus 0); Cost (2 Versus 2); Support (1 versus 1). Three subjects had daily asthma symptoms (DAS) initially versus one at follow-up.  

Conclusions: This asthma adherence disease management program yielded 77% SA and also reduced daily asthma symptoms in 2 of 3 subjects. Most common barriers initially were Psychological, QoL, and Medical concerns. Most common barriers at follow-up were Psychological. Three subjects no longer had Primary Medical Concern barriers. Allergists, employing the Asthma Adherence Pathway App, were successful in promoting subject adherence over 3 months.