Adherence to inhaled corticosteroids and long-acting β2-agonists in asthma: A MASK-air study

Adherence to controller medication is a major problem in asthma management, being difficult to assess and tackle. mHealth apps can be used to assess adherence. We aimed to assess the adherence to inhaled corticosteroids+long-acting β2-agonists (ICS+LABA) in users of the MASK-air® app, comparing the...

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Published in:	Pulmonology Vol. 31; no. 1; p. 2416869
Main Authors:	Sousa-Pinto, B., Louis, R., Anto, J.M., Amaral, R., Sá-Sousa, A., Czarlewski, W., Brussino, L., Canonica, G.W., Chaves Loureiro, C., Cruz, A.A., Gemicioglu, B., Haahtela, T., Kupczyk, M., Kvedariene, V., Larenas-Linnemann, D.E., Okamoto, Y., Ollert, M., Pfaar, O., Pham-Thi, N., Puggioni, F., Regateiro, F.S., Romantowski, J., Sastre, J., Scichilone, N., Taborda-Barata, L., Ventura, M.T., Agache, I., Bedbrook, A., Becker, S., Bergmann, K.C., Bosnic-Anticevich, S., Bonini, M., Boulet, L.-P., Brusselle, G., Buhl, R., Cecchi, L., Charpin, D., de Blay, F., Del Giacco, S., Ivancevich, J.C., Jutel, M., Klimek, L., Kraxner, H., Kuna, P., Laune, D., Makela, M., Morais-Almeida, M., Nadif, R., Niedoszytko, M., Papadopoulos, N.G., Papi, A., Patella, V., Pétré, B., Rivero Yeverino, D., Robalo Cordeiro, C., Roche, N., Rouadi, P.W., Samolinski, B., Savouré, M., Shamji, M.H., Sheikh, A., Suppli Ulrik, C., Usmani, O.S., Valiulis, A., Yorgancioglu, A., Zuberbier, T., Fonseca, J.A., Costa, E.M., Bousquet, J.
Format:	Journal Article
Language:	English
Published:	United States Elsevier España, S.L.U 31.12.2025 Informa UK Limited Taylor & Francis
Subjects:	[SDV]Life Sciences [q-bio] Adherence Adherence; Asthma; Formoterol; Inhaled corticosteroids; Long-acting-β2 agonist Administration, Inhalation Adrenal Cortex Hormones - administration & dosage Adrenal Cortex Hormones - therapeutic use Adrenergic beta-2 Receptor Agonists - administration & dosage Adrenergic beta-2 Receptor Agonists - therapeutic use Adult Aged Anti-Asthmatic Agents - administration & dosage Anti-Asthmatic Agents - therapeutic use Asthma Asthma - drug therapy Drug Therapy, Combination Female Formoterol Formoterol Fumarate - administration & dosage Formoterol Fumarate - therapeutic use Humans Inhaled corticosteroids Internal Medicine Life Sciences Long-acting-b2 agonist Long-acting-β2 agonist Male Medication Adherence Middle Aged Mobile Applications Pulmonary/Respiratory MASK-air DATs CSMS VAS Inhaled corticosteroids SABA Long-acting-β2 agonist MPR Asthma Adherence MART e-DASTHMA EMDs INCS LABA Formoterol GDPR EAACI-ARIA allergy combined symptom-medication score Visual analogue scale Electronic monitoring devices Medication possession ratio Electronic daily control score for asthma General Data Protection Regulation Long-acting β2 agonists Mobile Airways Sentinel networK for airway diseases Digital adherence technologies MAintenance and Reliever Therapy Short-acting beta-agonists
ISSN:	2531-0437, 2531-0429, 2531-0437
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Summary:	Adherence to controller medication is a major problem in asthma management, being difficult to assess and tackle. mHealth apps can be used to assess adherence. We aimed to assess the adherence to inhaled corticosteroids+long-acting β2-agonists (ICS+LABA) in users of the MASK-air® app, comparing the adherence to ICS+formoterol (ICS+F) with that to ICS+other LABA. We analysed complete weeks of MASK-air® data (2015-2022; 27 countries) from patients with self-reported asthma and ICS+LABA use. We compared patients reporting ICS+F versus ICS+other LABA on adherence levels, symptoms and symptom-medication scores. We built regression models to assess whether adherence to ICS+LABA was associated with asthma control or short-acting beta-agonist (SABA) use. Sensitivity analyses were performed considering the weeks with no more than one missing day. In 2598 ICS+LABA users, 621 (23.9%) reported 4824 complete weeks and 866 (33.3%) reported weeks with at most one missing day. Higher adherence (use of medication ≥80% of weekly days) was observed for ICS+other LABA (75.1%) when compared to ICS+F (59.3%), despite both groups displaying similar asthma control and work productivity. The ICS+other LABA group was associated with more days of SABA use than the ICS+F group (median=71.4% versus 57.1% days). Each additional weekly day of ICS+F use was associated with a 4.1% less risk in weekly SABA use (95%CI=-6.5;-1.6%;p=0.001). For ICS+other LABA, the percentage was 8.2 (95%CI=-11.6;-5.0%;p<0.001). In asthma patients adherent to the MASK-air app, adherence to ICS+LABA was high. ICS+F users reported lower adherence but also a lower SABA use and a similar level of control.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	2531-0437 2531-0429 2531-0437
DOI:	10.1016/j.pulmoe.2023.07.004