University of Oulu

Vähätalo I, Ilmarinen P, Tuomisto LE,et al. 12-year adherence to inhaledcorticosteroids in adult-onset asthma. ERJ Open Res 2020; 6: 00324-2019 [].

12-year adherence to inhaled corticosteroids in adult-onset asthma

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Author: Vähätalo, Iida1; Ilmarinen, Pinja1; Tuomisto, Leena E.1;
Organizations: 1Dept of Respiratory Medicine, Seinäjoki Central Hospital, Seinäjoki, Finland
2Dept of Laboratory Medicine, Seinäjoki Central Hospital, Seinäjoki, Finland
3Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
4Allergy Centre, Tampere University Hospital, Tampere, Finland
5Medical Informatics and Statistics Research Group, University of Oulu, Oulu, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.8 MB)
Persistent link:
Language: English
Published: European Respiratory Society, 2020
Publish Date: 2020-07-03


Adherence to inhaled corticosteroids (ICS) has been suggested to be poor but long-term follow-ups are lacking. The objective of the present study was to assess adherence to ICS treatment in patients with adult-onset asthma during 12-year follow-up.

A total of 181 patients with clinically confirmed, new-onset adult asthma were followed for 12 years as part of the Seinäjoki Adult Asthma Study. Adherence to ICS was assessed individually as the percentage of true dispensed ICS in micrograms per true prescribed daily ICS in micrograms over 12 years.

Mean 12-year adherence to ICS was 69% (mean±sd dispensed 2.5±1.8 g and prescribed 3.6±1.5 g budesonide equivalent per patient for 12 years), annual adherence varying between 81% (year 1) and 67% (year 12). Patients with good 12-year adherence (≥80%) used oral corticosteroids more often, and had add-on drugs in use and asthma-related visits to healthcare more often. In addition, they showed less reversibility in forced expiratory volume in 1 s and had higher peripheral blood neutrophil counts. However, lung function decline was steeper in patients with poorer adherence (<80%) and this association remained in multiple linear regression analysis. No difference was found in symptom scores, blood eosinophil counts, exhaled nitric oxide or immunoglobulin E between the patients with different levels of adherence.

In patients with adult-onset asthma, adherence to ICS was moderate. Poorer adherence (<80%) to ICS was associated with more rapid decline in lung function but was not associated to symptoms or markers of inflammatory endotypes.

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Series: ERJ open research
ISSN: 2312-0541
ISSN-E: 2312-0541
ISSN-L: 2312-0541
Volume: 6
Issue: 1
Article number: UNSP 324
DOI: 10.1183/23120541.00324-2019
Type of Publication: A1 Journal article – refereed
Field of Science: 3121 General medicine, internal medicine and other clinical medicine
317 Pharmacy
Funding: This study is funded by the Tampere Tuberculosis Foundation (Tampere, Finland), the Finnish Anti-Tuberculosis Association Foundation (Helsinki, Finland), the Research Foundation of the Pulmonary Diseases (Helsinki, Finland), the Ida Montini Foundation (Kerava, Finland), the Pirkanmaa Regional Fund of the Finnish Cultural Foundation (Helsinki, Finland), Allergy Research Foundation (Helsinki, Finland), Competitive State Research Financing of the Expert Responsibility Area of Tampere University Hospital (Tampere, Finland) and the Medical Research Fund of Seinäjoki Central Hospital (Seinäjoki, Finland). None of the sponsors had any involvement in the planning, execution, drafting or write-up of this study. Funding information for this article has been deposited with the Crossref Funder Registry.
Copyright information: © ERS 2020. This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial Licence 4.0.