193:
Real-Life Patterns of Asthma Controller Use Vary by Age, Time of Day and Season
Saturday, March 3, 2018
South Hall A2 (Convention Center)
Leanne Kaye, PhD, Heather Hoch, MD, Stanley J. Szefler, MD FAAAAI, William Anderson, MD, Meredith Barrett, PhD, David Van Sickle, PhD, David A. Stempel, MD FAAAAI
RATIONALE: Electronic inhaler sensors passively monitor patterns of asthma controller medication use enabling the objective evaluation of the temporal patterns of daily controller medication use for children and adults.

METHODS: Patients with asthma actively enrolled with a sensor and the Propeller Health platform for 8 or more weeks were included after their first use of a controller medication. The prescribed medication and recommended dosing schedule were recorded. Patient adherence to these recommendations were studied including patterns of adherence by age, time of day, and season.

RESULTS: The analysis included 1394 participants with 11,155 patient/weeks of data. Medication adherence incrementally improved by advancing age group with mean weekly adherence of 40.7% for those 12-25 years of age and 65% for 60+. The differences were statistically significant p <0.001. Adherence for those <12 was 47%, possibly reflecting parental assistance. Adherence was highest in the winter months for adults and fall/ winter for those <18. Adherence declined in the summer months, with reduction greatest in children from a peak of 52-54% in fall and winter months to 35% in July. Most patients (70%) were prescribed twice daily dosing with 56% adhering to both doses and 22% to either the AM or PM dose only. Mean adherence for combination ICS/LABA was 15% higher than ICS monotherapy.

CONCLUSIONS: Patterns of controller medication adherence varies by age, time of day, and season for patients with asthma. Such insights should play a pivotal role in developing personalized programs to improve adherence among adults and children with asthma.