Search:
Computing and Library Services - delivering an inspiring information environment

Inhaled corticosteroids for asthma: impact of practice level device switching on asthma control

Thomas, Mike, Price, David, Chrystyn, Henry, Lloyd, Andrew, Williams, Angela E. and von Ziegenweidt, Julie (2009) Inhaled corticosteroids for asthma: impact of practice level device switching on asthma control. BMC Pulmonary Medicine, 9 (1). pp. 1-10. ISSN 1471-2466

[img]
Preview
PDF - Published Version
Available under License Creative Commons Attribution.

Download (571kB) | Preview

    Abstract

    Background
    As more inhaled corticosteroid (ICS) devices become available, there may be pressure for health-care providers to switch patients with asthma to cheaper inhaler devices. Our objective was to evaluate impact on asthma control of inhaler device switching without an accompanying consultation in general practice.

    Methods
    This 2-year retrospective matched cohort study used the UK General Practice Research Database to identify practices where ICS devices were changed without a consultation for ≥5 patients within 3 months. Patients 6–65 years of age from these practices whose ICS device was switched were individually matched with patients using the same ICS device who were not switched. Asthma control over 12 months after the switch was assessed using a composite measure including short-acting β-agonist and oral corticosteroid use, hospitalizations, and subsequent changes to therapy.

    Results
    A total of 824 patients from 55 practices had a device switch and could be matched. Over half (53%) of device switches were from dry powder to metered-dose inhalers. Fewer patients in switched than matched cohort experienced successful treatment based on the composite measure (20% vs. 34%) and more experienced unsuccessful treatment (51% vs. 38%). After adjusting for possible baseline confounding factors, the odds ratio for treatment success in the switched cohort compared with controls was 0.29 (95% confidence interval [CI], 0.19 to 0.44; p < 0.001) and for unsuccessful treatment was 1.92 (95% CI, 1.47 to 2.56; p < 0.001).

    Conclusion
    Switching ICS devices without a consultation was associated with worsened asthma control and is therefore inadvisable.

    Item Type: Article
    Subjects: R Medicine > RS Pharmacy and materia medica
    Schools: School of Applied Sciences
    Related URLs:
    Depositing User: Graham Stone
    Date Deposited: 24 Nov 2009 16:55
    Last Modified: 28 Jul 2010 19:50
    URI: http://eprints.hud.ac.uk/id/eprint/6362

    Document Downloads

    Downloader Countries

    More statistics for this item...

    Item control for Repository Staff only:

    View Item

    University of Huddersfield, Queensgate, Huddersfield, HD1 3DH Copyright and Disclaimer All rights reserved ©