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Application of Once-Monthly Self-Reported ACT Questionnaire in Management of Adherence to Inhalers in Outpatients with Asthma

Authors Zhang J, Yin C, Li H, Wei W, Gong Y, Tang F

Received 25 February 2020

Accepted for publication 26 May 2020

Published 19 June 2020 Volume 2020:14 Pages 1027—1036


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Naifeng Liu

Jing Zhang,1,2,* Chengchen Yin,1,3,4,* Hongfang Li,1,3,4 Weipeng Wei,1,3,4 Yuansha Gong,5 Fushan Tang1,3,4

1Department of Clinical Pharmacy, School of Pharmacy, Zunyi Medical University, Zunyi 563006, People’s Republic of China; 2Department of Respiratory Medicine, Central Hospital in Jinchang City (Worker’s Hospital of Jinchuan Group), Jinchang 737102, People’s Republic of China; 3The Key Laboratory of Clinical Pharmacy in Zunyi City, Zunyi Medical University, Zunyi 563006, People’s Republic of China; 4Key Laboratory of Basic Pharmacology of Ministry of Education and Joint International Research Laboratory of Ethnomedicine of Ministry of Education, Zunyi Medical University, Zunyi 563006, People’s Republic of China; 5School of Nursing, Zunyi Medical University, Zunyi 563006, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Fushan Tang
Department of Clinical Pharmacy School of Pharmacy, Zunyi Medical University, Zunyi 563006, People’s Republic of China
Tel +86 851 2864 2337
Fax +86 851 2864 2334

Purpose: Poor medication adherence can negatively affect health outcomes of patients with asthma from medication and significantly increase the healthcare costs. Management of adherence to inhalers remains a challenging topic in the long-term management of patients with asthma. We aim to evaluate the role of asthma control test (ACT) in the management of adherence to inhalers in outpatients with asthma.
Patients and Methods: Six hundred twenty-seven outpatients with asthma admitted to the clinic of respiratory medicine in a tertiary hospital in northwestern China during 2016 to 2019 were randomly divided into observation group (n= 315) and control (n= 312) and received standard inhalant therapy for 6 months and lung function test before and after treatment. The patients in the observation group took ACT questionnaires at the end of each month, while the patients in control only took an ACT at the end of the last month. The ‘Test of Adherence to Inhalers’ (TAI) questionnaire was used to evaluate the patients’ adherence to inhalant therapy.
Results: All patients completed the study. The ACT scores in the observation group showed a gradual increase month by month. The TAI results indicated that adherence to inhalers of patients in the observation group was significantly better than that in control and the patients’ non-adherence pattern in the observation group, with significantly lower erratic non-adherence, was also different from that in control. After 6 months of treatment, the lung function indexes and their relative improvement and the ACT scores in the observation group were significantly better or higher than those in control.
Conclusion: The once-monthly self-reported ACT can effectively improve the adherence to inhalers of outpatients with asthma mainly by addressing erratic non-adherence and improve the treatment effects, and thus deserves widespread use in the treatment adherence management in patients with asthma.

Keywords: asthma control test, ACT, medication adherence, Test of Adherence to Inhalers, TAI, self-management, China

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