Annual General Meeting of the Irish Thoracic Society - IJMS | Irish ...

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SESSION TWO ONE
ANNUAL MEETING OF THE IRISH THORACIC SOCIETY • 11 - 12 November 2005 • WESTWOOD HOUSE HOTEL, GALWAY
Session 2: Asthma
ANNUAL MEETING OF THE IRISH THORACIC SOCIETY • 11 - 12 November 2005 • WESTWOOD HOUSE HOTEL, GALWAY
2
SESSION
SESSION TWO ONE
2.1
Introduction
Non-adherence to medication is a probable
cause of poor control in some difficult asthma
cases. Management strategies which address this
issue need to be studied; however we first need
to understand the extent of the problem. We
determined the number of patients attending our
difficult asthma service, who were significantly nonadherent
to inhaled corticosteroids, (prescription
filling of ≤50% of prescribed).
Non-adherence remains a problem in difficult asthma
prescribed inhaled steroids, 10 (17%) were taking 10 -
20%, 17 (30%) were taking 31-40% and 26 (46%) were
taking 41-50%. Of those taking ≥ 50% medication [79
(55%)], 24 (30%) were taking >100%, 36(46%) were
taking 71-100% and 19(24%) were taking 51-70%.
Many of those who were non-adherent requested
multiple beta-agonist inhalers (6 month period,
median 8, range 0 to 88), suggesting that symptoms
remained prominent and retrieving prescriptions
was not the primary problem.
J Gamble, A Lazenbatt,
LG Heaney
Belfast City Hospital
2.3
osteoporosis or osteopenia. Patients with these
conditions tended to be older. However, this is a
younger group than expected for these conditions.
Severity of asthma did not seem to affect level of
osteoporosis in both genders. Overall t - scores were
lower in the spine compared to the hip.
Conclusions
This audit showed high incidence of reduced
BMD in this group of asthma patients. Patients
with more difficult to treat asthma need bone
health assessments. Further studies focussing on
osteoporosis treatment, preventative strategies and
evaluation of such measures are required.
Fluticasone propionate/salmeterol in combination improves
health outcomes and quality of life in children with poorly
controlled asthma in Ireland
Method
Patient prescription refill data for inhaled
corticosteroids for the preceding 6 months was
obtained from GPs. Refill rates were compared
to prescribed medication and expressed as a
percentage.
Results
143 subjects were assessed, of those 57 (40%) were
non-adherent [7 (5%) none available]. Of those who
were non-adherent 4 (7%) were taking < 10% of
2.2
Introduction
Assessment for the development of osteoporosis in
the asthma population using Dexa scanning is now
becoming more common. To evaluate bone health
of asthma patients in SJH, a retrospective audit was
performed.
Method
Data was analysed on 74 patients (58 F, 16M) mean
age 55.27 +/- 12.23, attending a difficult to manage
asthma clinic. FEV1 % predicted ranged between 38-
Conclusion
Despite severe symptoms and attendance at a
difficult asthma service a significant proportion
of patients remain non-adherent to inhaled
corticosteroid therapy. These results support the
need for the development of strategies to improve
adherence in this population. It also suggests that
objective review of computerised prescribing records
should be a mandatory part of the assessment of
difficult asthma.
Osteoporosis in the difficult to treat asthma population
N=74
NORMAL BMD
N = 31.1%
OSTEOPENIA
N = 41.9 %
112%. Patients were randomly referred for Dexa scans
between 1999-2005. Anova and Chi square analysis
was used to examine relationship between bone
mass density (BMD) and other variables.
Results
See table below.
Discussion
High rates of osteoporosis and osteopenia were
found in this population. 2/3 of patients have either
OSTEOPOROSIS
N = 27%
P VALUE
Mean age (SD) 49.91 +/-12.87 56.61 +/- 10.37 60.6 +/- 10.6 P=2 points
between w0 and w16*. Mean day and night time
symptoms scores improved by 1.5 points* and 1.6*
points respectively between w0 and w16. Patients
reported a mean of 3.9 more days per week without
asthma symptoms and 4.6 fewer days using short
acting βtwo agonist medication per week between
w0 and w16*. Children missed 1.6 fewer school days
per month between w0 and w16*. Carers missed a
mean of 1.2 fewer days per month from work*. No
treatment related adverse events were reported.
Conclusions
SFC significantly improved asthma symptoms,
quality of life and daily activities of uncontrolled
paediatric asthma patients and their families.
* P