Relationship of Adherence Estimator TM Scores to Exhaled Nitric Oxide Levels in Pediatric Asthma Patients
Sunday, March 6, 2016
South Exhibit Hall H (Convention Center)
Suzanne Burke-McGovern, MD, Yan Yan, Haesoon Lee, Rauno Joks, M.D.
Rationale: Non-adherence to inhaled corticosteroid (ICS) therapy is a major factor contributing to increased morbidity and mortality in pediatric patients with persistent asthma.  Exhaled nitric oxide ( FeNO) levels are utilized as a measure of airway inflammation and ICS adherence in asthmatics. This test is costly and difficult for some children to perform.  We set out to determine how adherence using  a “low tech” (debatable) tool, i.e. the Adherence Estimator TM(AE) (Merck, Inc) compares to FeNO measurements in pediatric asthmatic patients.

Methods: Forty-three pediatric patients (ages 5-18 yrs) with persistent asthma were recruited from the Pediatric Asthma Center at the University Hospital of Brooklyn.  Each patient had been prescribed an ICS. Participants and parents completed an Asthma Control Test (ACT) and AE Questionnaire, a measure validated in adult chronic diseasepopulation to assess medication non-adherence risk.  FeNO (Aerocrine, Inc) levels were measured.  Spearman rank correlation coefficients (rho) were generated

Results: Sixty percent (n=26) of subjects had an elevated FeNO level (≥20ppb) and 60% (n=26) had poorly controlled asthma according to ACT.  Forty-seven  percent (n=20) had medium to high risk of medication non-adherence.  There was a significant positive correlation between FeNO and Adherence Estimator scores (p=0.006).

Conclusions: The Adherence Estimator TM may be as effective in measuring medication adherence as FENO levels. Use of Adherence Estimator scores and FENO levels may help assure adequate adherence in pediatric asthma care.