Inhaled corticosteroids for asthma: impact of practice level device switching on asthma control
2009

Impact of Switching Inhaler Devices on Asthma Control

Sample size: 824 publication 10 minutes Evidence: high

Author Information

Author(s): Thomas Mike, Price David, Chrystyn Henry, Lloyd Andrew, Williams Angela E, von Ziegenweidt Julie

Primary Institution: University of Aberdeen

Hypothesis

Switching inhaler device without a consultation is associated with worsened clinical outcomes for patients with asthma.

Conclusion

Switching ICS devices without a consultation was associated with worsened asthma control and is therefore inadvisable.

Supporting Evidence

  • 53% of device switches were from dry powder to metered-dose inhalers.
  • 20% of switched patients experienced successful treatment compared to 34% of controls.
  • Switched patients had an odds ratio of 0.29 for treatment success compared to controls.

Takeaway

Changing asthma inhalers without talking to a doctor can make asthma worse. It's better to have a consultation before switching.

Methodology

This was a 2-year retrospective matched cohort study using the UK General Practice Research Database to analyze asthma control after inhaler device switching.

Potential Biases

Potential bias due to incomplete recording of consultations and the retrospective nature of the study.

Limitations

The study is limited by the completeness and accuracy of the database used, and findings may not reflect clinical significance despite statistical significance.

Participant Demographics

Patients aged 6–65 years with a diagnosis of asthma, matched by sex, age, smoking status, and other health factors.

Statistical Information

P-Value

<0.001

Confidence Interval

0.19 to 0.44

Statistical Significance

p<0.001

Digital Object Identifier (DOI)

10.1186/1471-2466-9-1

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