• J Am Board Fam Med · Aug 2023

    What Patients Call Their Inhalers Is Associated with "Asthma Attacks".

    • Victoria E Forth, Juan Carlos Cardet, Ku-Lang Chang, Brianna Ericson, Laura P Hurley, Nancy E Maher, Elizabeth W Staton, Bonnie Telón Sosa, Elliot Israel, and PREPARE investigators.
    • From the Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Boston, MA (VEF, BE, NEM, EI, PAH, JK, JRL, JC, JDS); Division of Allergy and Immunology, Department of Internal Medicine, University of South Florida, Morsani College of Medicine, Tampa, FL (JCC); Denver Health and Hospital Authority, Denver, CO (LPH); Lucas Research, Morehead City, NC (KLC); American Academy of Family Physicians National Research Network, Leawood, KS (EWS, JKC, BKM, WDP, JBS); University of Colorado Department of Family Medicine, Aurora, CO (EWS, JKC); Department of Internal Medicine, Allergy/Immunology Section, University of Puerto Rico, San Juan, PR (BTS); Division of Allergy and Immunology, Brigham and Women's Hospital, Boston, MA (EI); Pulmonary Science and Critical Care Medicine, Department of Medicine, University of Colorado School of Medicine, Aurora, CO (ALF); DARTNet Institute, Aurora, CO (WDP); Division of Immunology, Boston Children's Hospital, Boston, MA (WP); University of Miami Health System, Miami, FL (MF); Division of Allergy and Immunology, Department of Medicine, NorthShore University Health System, Glenview, IL (GM); Morehouse School of Medicine, Atlanta, GA (FO).
    • J Am Board Fam Med. 2023 Aug 9; 36 (4): 650661650-661.

    BackgroundClinician-patient miscommunication contributes to worse asthma outcomes. What patients call their asthma inhalers and its relationship with asthma morbidity are unknown.MethodsInhaler names were ascertained from Black and Latinx adults with moderate-severe asthma and categorized as "standard" if based on brand/generic name or inhaler type (i.e., controller vs. rescue) or "non-standard" for other terms (i.e., color, device type, e.g., "puffer," or unique names). Clinical characteristics and asthma morbidity measures were evaluated at baseline: self-reported asthma exacerbations one year before enrollment (i.e., systemic corticosteroid bursts, emergency department (ED)/urgent care (UC) visits, or hospitalizations), and asthma control and quality of life. Multivariable regression models tested the relationship between non-standard names and asthma morbidity measures, with adjustments.ResultsForty-four percent (502/1150) of participants used non-standard inhaler names. These participants were more likely to be Black (p=0.006), from the Southeast (p<0.001), and have fewer years with asthma (p=0.012) relative to those who used standard names. Non-standard inhaler names was associated with an incidence rate ratio (IRR) of 1.29 (95% confidence interval [CI], 1.11-1.50, p=0.001; 1.8 vs. 1.5 events) for corticosteroid bursts for asthma, an IRR=1.43 (95% CI, 1.21-1.69, p<0.001; 1.9 vs. 1.4 events) for ED/UC visits for asthma, and an odds ratio=1.57 (95% CI, 1.12-2.18, p=0.008; 0.5 vs. 0.3 events) for asthma hospitalizations after adjustment.ConclusionsPatients who use non-standard names for asthma inhalers experience increased asthma morbidity. Ascertaining what patients call their inhalers may be a quick method to identify those at higher risk of poor outcomes.© Copyright by the American Board of Family Medicine.

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