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Improving Inhaler Adherence in a Clinical Trial Through the Use of the Nebulizer Chronolog

1993; Elsevier BV; Volume: 104; Issue: 2 Linguagem: Inglês

10.1378/chest.104.2.501

1931-3543

Mitchell Nides, Donald P. Tashkin, Michael S. Simmons, Robert A. Wise, Virginia C. Li, Cynthia S. Rand,

Asthma and respiratory diseases

This study examined whether utilizing an electronic medication monitor (Nebulizer Chronolog) to provide participants with detailed feedback on their metered-dose inhaler (ipratropium bromide or placebo) usage patterns would result in closer adherence to the prescribed regimen of two inhalations three times daily compared to a control group not receiving feedback. Adherence was also measured by canister weighing and self-report. Two-hundred fifty-one consecutive special intervention participants from the University of California, Los Angeles, and Johns Hopkins University centers of a National Heart, Lung, and Blood Institute-sponsored clinical trial were enrolled in this ancillary study. Compared to controls, feedback participants at the 4-month follow-up adhered more closesly to the prescribed three sets per day (mean 1.95 vs 1.65) and used the prescribed two actuations in a greater percentage of sets (80 percent vs 60.3 percent). These results indicate that electronic monitoring of metered-dose inhaler use with a Nebulizer Chronolog in a clinical trial not only provides a more accurate assessment of adherence to prescribed inhaler use, but also enhances adherence when participants are given feedback of the monitoring results. This study examined whether utilizing an electronic medication monitor (Nebulizer Chronolog) to provide participants with detailed feedback on their metered-dose inhaler (ipratropium bromide or placebo) usage patterns would result in closer adherence to the prescribed regimen of two inhalations three times daily compared to a control group not receiving feedback. Adherence was also measured by canister weighing and self-report. Two-hundred fifty-one consecutive special intervention participants from the University of California, Los Angeles, and Johns Hopkins University centers of a National Heart, Lung, and Blood Institute-sponsored clinical trial were enrolled in this ancillary study. Compared to controls, feedback participants at the 4-month follow-up adhered more closesly to the prescribed three sets per day (mean 1.95 vs 1.65) and used the prescribed two actuations in a greater percentage of sets (80 percent vs 60.3 percent). These results indicate that electronic monitoring of metered-dose inhaler use with a Nebulizer Chronolog in a clinical trial not only provides a more accurate assessment of adherence to prescribed inhaler use, but also enhances adherence when participants are given feedback of the monitoring results. Feedback on Medication Dosing Enhances Patient ComplianceCHESTVol. 104Issue 2PreviewThe axiom "Patients tell us what they think we want to hear"1 now has a corollary: "Patients try to appear compliant for a visit to the doctor." In this issue, Nides et al (see page 501 ) report that 15 percent of patients who did not know how they were being monitored emptied their nebulizer just before the visit so that it would be light in weight when checked. Similar stories of pill dumping are well known in all fields of medicine. The issue of exactly how patients are taking their medications is crucial in a clinical trial in which determination of efficacy is made and reported to the medical community. Full-Text PDF