NDLI: A cluster-randomized trial to provide clinicians inhaled corticosteroid adherence information for their patients with asthma.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Williams, L. Keoki Peterson, Edward L. Wells, Karen Campbell, Janis Wang, Mingqun Chowdhry, Vimal K. Walsh, Matthew Enberg, Robert Lanfear, David E. Pladevall, Manel
Spatial Coverage	Michigan
Description	Country affiliation: United States Author Affiliation: Williams LK ( Center for Health Services Research, Henry Ford Health System, Detroit, MI 48202, USA. kwillia5@hfhs.org)
Abstract	BACKGROUND: Inhaled corticosteroid (ICS) nonadherence is common among patients with asthma; however, interventions to improve adherence have often been complex and not easily applied to large patient populations. OBJECTIVE: To assess the effect of supplying patient adherence information to primary care providers. METHODS: Patients and providers were members of a health system serving southeast Michigan. Providers (88 intervention; 105 control) and patients (1335 intervention; 1363 control) were randomized together by practice. Patients were age 5 to 56 years, had a diagnosis of asthma, and had existing prescriptions for ICS medication. Adherence was estimated by using prescription and fill data. Unlike clinicians in the control arm, intervention arm providers could view updated ICS adherence information on their patients via electronic prescription software, and further details on patient ICS use could be viewed by selecting that option. The primary outcome was ICS adherence in last 3 months of the study period. RESULTS: At the study end for the intention-to-treat analysis, ICS adherence was not different among patients in the intervention arm compared with those in the control arm (21.3% vs 23.3%, respectively; P = .553). However, adherence was significantly higher among patients whose clinician elected to view their detailed adherence information (35.7%) compared with both control arm patients (P = .026) and intervention arm patients whose provider did not view adherence data (P = .002). CONCLUSIONS: Overall, providing adherence information to clinicians did not improve ICS use among patients with asthma. However, patient use may improve when clinicians are sufficiently interested in adherence to view the details of this medication use.
File Format	HTM / HTML
ISSN	00916749
e-ISSN	10976825
DOI	10.1016/j.jaci.2010.03.034
Journal	Journal of Allergy and Clinical Immunology
Issue Number	2
Volume Number	126
Language	English
Publisher	Elsevier
Publisher Date	2010-08-01
Publisher Place	United States
Access Restriction	Open
Subject Keyword	Discipline Immunology Adrenal Cortex Hormones Administration & Dosage Asthma Drug Therapy Electronic Prescribing Health Personnel Medication Adherence Administration, Inhalation Adolescent Epidemiology Child, Preschool Hospital Information Systems Michigan Time Factors Comparative Study Randomized Controlled Trial Research Support, N.i.h., Extramural Research Support, Non-u.s. Gov't
Content Type	Text
Resource Type	Article
Subject	Immunology and Allergy Immunology

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