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An investigation of inhaled corticosteroid adherence and lifetime emergency department visits for asthma / Erik A. Barrows

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Identifier	Thesis 1517
Author	Barrows, Erik A
Title	An investigation of inhaled corticosteroid adherence and lifetime emergency department visits for asthma / Erik A. Barrows
Publisher	Central Connecticut State University
Date	1999
Resource Type	Master's Thesis
Notes	Inhaled corticosteroids form the cornerstone of asthma treatment. They combat the inflammatory characteristics of asthma that result in bronchial hyperresponsiveness and overproduction of mucous. They do not have an immediate perceivable effect and acute asthma symptoms are not alleviated with their use. They are intended to be used as a preventive measure. We studied forty-nine asthma patients' self-administration of their inhaled steroid medication. The inclusion criteria consisted of asthma patients with moderate to severe asthma as defined by the NHBLI guidelines. These guidelines stated a person whose lungs function was below 80% predicted FEV-1 pre-bronchodilator with a 15% or above reversibility of asthma symptoms post-bronchodilator is considered to have moderate to severe asthma. The volunteers were recruited from University of Connecticut Health Center and St. Francis Hospital and Medical Center outpatients clinics. There were two patient visits during a six-week time period where questionnaires, asthma history and demographics were recorded. The investigation was designed to follow participants' self-administration of their inhaled corticosteroid for six weeks using an MDI Chronolog™ device. The benefit of using MDI Chronologs™ was we did not rely upon patients' self-reporting of their inhaled corticosteroid medications. It recorded the date and time of every actuation of medication. This data was downloaded onto a personal computer after their six-week participation. We followed patient adherence with their asthma medications to analyze the group's individual characteristics and investigate any aspects that are common. We did rely upon patients' self-reporting of their asthma histories, and lifetime emergency department visits. The Pearson's Rank Coefficient show a 0.807 correlation between inhaled corticosteroid medication and emergency department visits for asthma. Previous studies show that using emergency departments to treat asthma symptoms, correlate with a lack of confidence in patients' ability to control their asthma. These asthma patients rely upon outside intervention to maintain their asthma health. Our study results indicate emergency department visits for asthma may also be used as a guide for physicians to have a basic knowledge of how patients take their medication. Numbers of emergency department visits can also show a lack of understanding about inhaled corticosteroid function. Physicians normally increase the amount of inhaled corticosteroid medication for their patients when asthma is not controlled. They also may prescribe oral corticosteroids to treat their patients' asthma. Patients' health is the primary concern. However, emergency department visits can be seen as an indicator of a lack of asthma medication adherence and knowledge. Physicians can begin to teach patients about medication functioning in ways to maintain patients' health instead of or in combination with prescribing an increased dosage of medication. The hope is emergency department visits will not be seen as the only way to control their asthma. Patients will see themselves as having personal control over asthma symptoms rather than relying upon outside intervention, and therefore feel some control over their asthma health.
Subject	Asthma -- Treatment Adrenocortical hormones
Department	Department of Biological Sciences
Advisor	Watson, Cheryl L
Type	Text
Digital Format	application/pdf
Language	eng
OCLC number	42412211
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An investigation of inhaled corticosteroid adherence and lifetime emergency department visits for asthma / Erik A. Barrows

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