Patient-physician discordance in assessment of adherence to inhaled controller medication
| Autor(a) principal: | |
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| Data de Publicação: | 2019 |
| Outros Autores: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
| Tipo de documento: | Artigo |
| Idioma: | eng |
| Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
| Texto Completo: | https://doi.org/10.1136/bmjopen-2019-031732 |
Resumo: | CJ is a post-doc fellow (SFRH/BPD/115169/2016) funded by Fundação para a Ciência e Tecnologia (FCT), reimbursed by Fundo Social Europeu and by national funds of MCTES. This work was funded by ERDF (European Regional Development Fund) through the operations: POCI-01-0145-FEDER-029130 ('mINSPIRERS—mHealth to measure and improve adherence to medication in chronic obstructive respiratory diseases—generalisation and evaluation of gamification, peer support and advanced image processing technologies') cofunded by the COMPETE2020 (Programa Operacional Competitividade e Internacionalização), Portugal 2020 and by Portuguese Funds through FCT (Fundação para a Ciência e a Tecnologia). |
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Patient-physician discordance in assessment of adherence to inhaled controller medicationA cross-sectional analysis of two cohortsasthmadiscordancelogistic modelsmedication adherenceMedicine(all)CJ is a post-doc fellow (SFRH/BPD/115169/2016) funded by Fundação para a Ciência e Tecnologia (FCT), reimbursed by Fundo Social Europeu and by national funds of MCTES. This work was funded by ERDF (European Regional Development Fund) through the operations: POCI-01-0145-FEDER-029130 ('mINSPIRERS—mHealth to measure and improve adherence to medication in chronic obstructive respiratory diseases—generalisation and evaluation of gamification, peer support and advanced image processing technologies') cofunded by the COMPETE2020 (Programa Operacional Competitividade e Internacionalização), Portugal 2020 and by Portuguese Funds through FCT (Fundação para a Ciência e a Tecnologia).Objective We aimed to compare patient's and physician's ratings of inhaled medication adherence and to identify predictors of patient-physician discordance. Design Baseline data from two prospective multicentre observational studies. Setting 29 allergy, pulmonology and paediatric secondary care outpatient clinics in Portugal. Participants 395 patients (≥13 years old) with persistent asthma. Measures Data on demographics, patient-physician relationship, upper airway control, asthma control, asthma treatment, forced expiratory volume in one second (FEV 1) and healthcare use were collected. Patients and physicians independently assessed adherence to inhaled controller medication during the previous week using a 100 mm Visual Analogue Scale (VAS). Discordance was defined as classification in distinct VAS categories (low 0-50; medium 51-80; high 81-100) or as an absolute difference in VAS scores ≥10 mm. Correlation between patients' and physicians' VAS scores/categories was explored. A multinomial logistic regression identified the predictors of physician overestimation and underestimation. Results High inhaler adherence was reported both by patients (median (percentile 25 to percentile 75) 85 (65-95) mm; 53% VAS>80) and by physicians (84 (68-95) mm; 53% VAS>80). Correlation between patient and physician VAS scores was moderate (r s =0.580; p<0.001). Discordance occurred in 56% of cases: in 28% physicians overestimated adherence and in 27% underestimated. Low adherence as assessed by the physician (OR=27.35 (9.85 to 75.95)), FEV 1 ≥80% (OR=2.59 (1.08 to 6.20)) and a first appointment (OR=5.63 (1.24 to 25.56)) were predictors of underestimation. An uncontrolled asthma (OR=2.33 (1.25 to 4.34)), uncontrolled upper airway disease (OR=2.86 (1.35 to 6.04)) and prescription of short-acting beta-agonists alone (OR=3.05 (1.15 to 8.08)) were associated with overestimation. Medium adherence as assessed by the physician was significantly associated with higher risk of discordance, both for overestimation and underestimation of adherence (OR=14.50 (6.04 to 34.81); OR=2.21 (1.07 to 4.58)), while having a written action plan decreased the likelihood of discordance (OR=0.25 (0.12 to 0.52); OR=0.41 (0.22 to 0.78)) (R 2 =44%). Conclusion Although both patients and physicians report high inhaler adherence, discordance occurred in half of cases. Implementation of objective adherence measures and effective communication are needed to improve patient-physician agreement.NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)Centro de Estudos de Doenças Crónicas (CEDOC)RUNJácome, CristinaPereira, Ana MargaridaAlmeida, RuteFerreira-Magalhaes, ManuelCouto, MarianaAraujo, LuísPereira, MarianaCorreia, Magna AlvesLoureiro, Cláudia ChavesCatarata, Maria JoanaMaia Santos, LíliaPereira, JoãoRamos, BárbaraLopes, CristinaMendes, AnaCidrais Rodrigues, José CarlosOliveira, GeorgetaAguiar, Ana PaulaAfonso, IveteCarvalho, JoanaArrobas, AnaCoutinho Costa, JoséDias, JoanaTodo Bom, AnaAzevedo, JoãoRibeiro, CarmelitaAlves, MartaLeiria Pinto, PaulaNeuparth, NPalhinha, AnaGaspar Marques, JoãoPinto, NicoleMartins, PedroTodo Bom, FilipaAlvarenga Santos, MariaGomes Costa, AlbertoSilva Neto, ArmandinaSantalha, MartaLozoya, CarlosSantos, NatachaSilva, DianaVasconcelos, Maria JoãoTaborda-Barata, LuísCarvalhal, CéliaTeixeira, Maria FernandaAlves, Rodrigo RodriguesMoreira, Ana SofiaSofia Pinto, CláudiaMorais Silva, PedroAlves, CarlosCâmara, RaquelCoelho, DidinaBordalo, DianaFernandes, Ricardo M.Ferreira, RosárioMenezes, FernandoGomes, RicardoCalix, Maria JoséMarques, AnaCardoso, JoãoEmiliano, MadalenaGerardo, RitaNunes, CarlosCâmara, RitaFerreira, José AlbertoCarvalho, AuroraFreitas, PauloCorreia, RicardoFonseca, Joao A.2019-11-21T23:18:09Z2019-11-012019-11-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttps://doi.org/10.1136/bmjopen-2019-031732eng2158-2440PURE: 15522040http://www.scopus.com/inward/record.url?scp=85074692327&partnerID=8YFLogxKhttps://doi.org/10.1136/bmjopen-2019-031732info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2024-03-11T04:39:11Zoai:run.unl.pt:10362/88020Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-20T03:36:48.625179Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
| dc.title.none.fl_str_mv |
Patient-physician discordance in assessment of adherence to inhaled controller medication A cross-sectional analysis of two cohorts |
| title |
Patient-physician discordance in assessment of adherence to inhaled controller medication |
| spellingShingle |
Patient-physician discordance in assessment of adherence to inhaled controller medication Jácome, Cristina asthma discordance logistic models medication adherence Medicine(all) |
| title_short |
Patient-physician discordance in assessment of adherence to inhaled controller medication |
| title_full |
Patient-physician discordance in assessment of adherence to inhaled controller medication |
| title_fullStr |
Patient-physician discordance in assessment of adherence to inhaled controller medication |
| title_full_unstemmed |
Patient-physician discordance in assessment of adherence to inhaled controller medication |
| title_sort |
Patient-physician discordance in assessment of adherence to inhaled controller medication |
| author |
Jácome, Cristina |
| author_facet |
Jácome, Cristina Pereira, Ana Margarida Almeida, Rute Ferreira-Magalhaes, Manuel Couto, Mariana Araujo, Luís Pereira, Mariana Correia, Magna Alves Loureiro, Cláudia Chaves Catarata, Maria Joana Maia Santos, Lília Pereira, João Ramos, Bárbara Lopes, Cristina Mendes, Ana Cidrais Rodrigues, José Carlos Oliveira, Georgeta Aguiar, Ana Paula Afonso, Ivete Carvalho, Joana Arrobas, Ana Coutinho Costa, José Dias, Joana Todo Bom, Ana Azevedo, João Ribeiro, Carmelita Alves, Marta Leiria Pinto, Paula Neuparth, N Palhinha, Ana Gaspar Marques, João Pinto, Nicole Martins, Pedro Todo Bom, Filipa Alvarenga Santos, Maria Gomes Costa, Alberto Silva Neto, Armandina Santalha, Marta Lozoya, Carlos Santos, Natacha Silva, Diana Vasconcelos, Maria João Taborda-Barata, Luís Carvalhal, Célia Teixeira, Maria Fernanda Alves, Rodrigo Rodrigues Moreira, Ana Sofia Sofia Pinto, Cláudia Morais Silva, Pedro Alves, Carlos Câmara, Raquel Coelho, Didina Bordalo, Diana Fernandes, Ricardo M. Ferreira, Rosário Menezes, Fernando Gomes, Ricardo Calix, Maria José Marques, Ana Cardoso, João Emiliano, Madalena Gerardo, Rita Nunes, Carlos Câmara, Rita Ferreira, José Alberto Carvalho, Aurora Freitas, Paulo Correia, Ricardo Fonseca, Joao A. |
| author_role |
author |
| author2 |
Pereira, Ana Margarida Almeida, Rute Ferreira-Magalhaes, Manuel Couto, Mariana Araujo, Luís Pereira, Mariana Correia, Magna Alves Loureiro, Cláudia Chaves Catarata, Maria Joana Maia Santos, Lília Pereira, João Ramos, Bárbara Lopes, Cristina Mendes, Ana Cidrais Rodrigues, José Carlos Oliveira, Georgeta Aguiar, Ana Paula Afonso, Ivete Carvalho, Joana Arrobas, Ana Coutinho Costa, José Dias, Joana Todo Bom, Ana Azevedo, João Ribeiro, Carmelita Alves, Marta Leiria Pinto, Paula Neuparth, N Palhinha, Ana Gaspar Marques, João Pinto, Nicole Martins, Pedro Todo Bom, Filipa Alvarenga Santos, Maria Gomes Costa, Alberto Silva Neto, Armandina Santalha, Marta Lozoya, Carlos Santos, Natacha Silva, Diana Vasconcelos, Maria João Taborda-Barata, Luís Carvalhal, Célia Teixeira, Maria Fernanda Alves, Rodrigo Rodrigues Moreira, Ana Sofia Sofia Pinto, Cláudia Morais Silva, Pedro Alves, Carlos Câmara, Raquel Coelho, Didina Bordalo, Diana Fernandes, Ricardo M. Ferreira, Rosário Menezes, Fernando Gomes, Ricardo Calix, Maria José Marques, Ana Cardoso, João Emiliano, Madalena Gerardo, Rita Nunes, Carlos Câmara, Rita Ferreira, José Alberto Carvalho, Aurora Freitas, Paulo Correia, Ricardo Fonseca, Joao A. |
| author2_role |
author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author |
| dc.contributor.none.fl_str_mv |
NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM) Centro de Estudos de Doenças Crónicas (CEDOC) RUN |
| dc.contributor.author.fl_str_mv |
Jácome, Cristina Pereira, Ana Margarida Almeida, Rute Ferreira-Magalhaes, Manuel Couto, Mariana Araujo, Luís Pereira, Mariana Correia, Magna Alves Loureiro, Cláudia Chaves Catarata, Maria Joana Maia Santos, Lília Pereira, João Ramos, Bárbara Lopes, Cristina Mendes, Ana Cidrais Rodrigues, José Carlos Oliveira, Georgeta Aguiar, Ana Paula Afonso, Ivete Carvalho, Joana Arrobas, Ana Coutinho Costa, José Dias, Joana Todo Bom, Ana Azevedo, João Ribeiro, Carmelita Alves, Marta Leiria Pinto, Paula Neuparth, N Palhinha, Ana Gaspar Marques, João Pinto, Nicole Martins, Pedro Todo Bom, Filipa Alvarenga Santos, Maria Gomes Costa, Alberto Silva Neto, Armandina Santalha, Marta Lozoya, Carlos Santos, Natacha Silva, Diana Vasconcelos, Maria João Taborda-Barata, Luís Carvalhal, Célia Teixeira, Maria Fernanda Alves, Rodrigo Rodrigues Moreira, Ana Sofia Sofia Pinto, Cláudia Morais Silva, Pedro Alves, Carlos Câmara, Raquel Coelho, Didina Bordalo, Diana Fernandes, Ricardo M. Ferreira, Rosário Menezes, Fernando Gomes, Ricardo Calix, Maria José Marques, Ana Cardoso, João Emiliano, Madalena Gerardo, Rita Nunes, Carlos Câmara, Rita Ferreira, José Alberto Carvalho, Aurora Freitas, Paulo Correia, Ricardo Fonseca, Joao A. |
| dc.subject.por.fl_str_mv |
asthma discordance logistic models medication adherence Medicine(all) |
| topic |
asthma discordance logistic models medication adherence Medicine(all) |
| description |
CJ is a post-doc fellow (SFRH/BPD/115169/2016) funded by Fundação para a Ciência e Tecnologia (FCT), reimbursed by Fundo Social Europeu and by national funds of MCTES. This work was funded by ERDF (European Regional Development Fund) through the operations: POCI-01-0145-FEDER-029130 ('mINSPIRERS—mHealth to measure and improve adherence to medication in chronic obstructive respiratory diseases—generalisation and evaluation of gamification, peer support and advanced image processing technologies') cofunded by the COMPETE2020 (Programa Operacional Competitividade e Internacionalização), Portugal 2020 and by Portuguese Funds through FCT (Fundação para a Ciência e a Tecnologia). |
| publishDate |
2019 |
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2019-11-21T23:18:09Z 2019-11-01 2019-11-01T00:00:00Z |
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info:eu-repo/semantics/publishedVersion |
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info:eu-repo/semantics/article |
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article |
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publishedVersion |
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https://doi.org/10.1136/bmjopen-2019-031732 |
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https://doi.org/10.1136/bmjopen-2019-031732 |
| dc.language.iso.fl_str_mv |
eng |
| language |
eng |
| dc.relation.none.fl_str_mv |
2158-2440 PURE: 15522040 http://www.scopus.com/inward/record.url?scp=85074692327&partnerID=8YFLogxK https://doi.org/10.1136/bmjopen-2019-031732 |
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info:eu-repo/semantics/openAccess |
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openAccess |
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application/pdf |
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