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
MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences; Faculty of Medicine, University of Porto, Porto, Portugal.
CINTESIS@RISE - Health Research Network, Faculty of Medicine, University of Porto, Porto, Portugal.
Pulmonology. 2025 Dec 31;31(1):2416869. doi: 10.1016/j.pulmoe.2023.07.004. Epub 2024 Oct 25.
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%;=0.001). For ICS+other LABA, the percentage was 8.2 (95%CI=-11.6;-5.0%;<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.
坚持使用控制药物是哮喘管理中的一个主要问题，难以评估和解决。移动健康应用程序可用于评估依从性。我们旨在评估使用MASK-air®应用程序的用户对吸入性糖皮质激素+长效β2受体激动剂（ICS+LABA）的依从性，比较ICS+福莫特罗（ICS+F）与ICS+其他LABA的依从性。
我们分析了来自27个国家自我报告患有哮喘且使用ICS+LABA的患者的MASK-air®完整周数据（2015 - 2022年）。我们比较了报告使用ICS+F与ICS+其他LABA的患者在依从性水平、症状及症状 - 药物评分方面的情况。我们构建回归模型以评估对ICS+LABA的依从性是否与哮喘控制或短效β受体激动剂（SABA）使用相关。考虑到缺失天数不超过一天的周数进行了敏感性分析。
在2598名ICS+LABA使用者中，621名（23.9%）报告了4824个完整周，866名（33.3%）报告了缺失天数最多为一天的周数。与ICS+F（59.3%）相比，ICS+其他LABA的依从性更高（每周用药天数≥80%）（75.1%），尽管两组的哮喘控制和工作效率相似。与ICS+F组相比，ICS+其他LABA组使用SABA的天数更多（中位数分别为71.4%和57.1%）。每周多使用一天ICS+F与每周使用SABA的风险降低4.1%相关（95%置信区间=-6.5；-1.6%；P = 0.001）。对于ICS+其他LABA，该百分比为8.2（95%置信区间=-11.6；-5.0%；P<0.001）。
在坚持使用MASK-air应用程序的哮喘患者中，对ICS+LABA的依从性较高。ICS+F使用者报告的依从性较低，但SABA使用量也较低且控制水平相似。
