Determining Persistence with an Inhaled Corticosteroid in Asthma: Assessment Using an Objective Measurement vs the Self-Reported Foster Score

• Main Authors: Hedegaard BO, Håkansson KEJ, Jensen FF, Ulrik CS, Weinreich UM
• Format: Article in Journal/Newspaper
• Language: English
• Published: Dove Medical Press 2022
• Subjects: foster score; medication possession ratio; controller medication; asthma; self-assessed adherence; self-reported outcome; adherence; persistence; Immunologic diseases. Allergy; RC581-607; Faroe Islands; Tórshavn; National hospital of the Faroe Islands
• Online Access: https://doaj.org/article/3d31713dac1b47259716fa121d08551a

Britt Overgaard Hedegaard,1 Kjell Erik Julius Håkansson,2 Frodi Fridason Jensen,2,3 Charlotte Suppli Ulrik,2,4 Ulla Møller Weinreich1,5 1Department of Respiratory Diseases, Aalborg University Hospital, Aalborg, Denmark; 2Department of Respiratory Medicine, Copenhagen University Hospital - Hvidovre, Hvidovre, Denmark; 3Medical Department, National Hospital of the Faroe Islands, Tórshavn, Faroe Islands; 4Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; 5The Clinical Institute, Aalborg University, Aalborg, DenmarkCorrespondence: Ulla Møller WeinreichDepartment of Respiratory Diseases, Aalborg University Hospital, Mølleparkvej 4, Aalborg, DK-9000, DenmarkEmail [e-mail]: Adherence with controller medication is a major challenge in asthma management. Thus, a reliable method of measurement is mandatory to assess adherence.Aim: To examine the test-retest reliability on adherence with inhaled corticosteroids in adults with asthma using, a self-reported adherence score (Foster score).Methods: Patients with asthma and > 1 routine follow-up appointment at a university hospital outpatient clinic reported Foster scores. The objective Medication Possession Ratio (MPR) was calculated based on pharmacy redemption data and physician-prescribed doses of inhaled corticosteroids. The difference between Foster score and MPR at the first and second visit was assessed using a Bland–Altman plot, outcomes reported as limits of agreements and bias. Foster scores from both visits were used to calculate an intraclass correlation coefficient (ICC).Results: Self-reported adherence with asthma controller medication measured by Foster score was significantly higher than the objective MPR (p < 0.0001). The Bland–Altman plot for MPR and Foster score at the first and second visit showed upper and lower limits of agreement of 83.5 – (− 1.6) and 80.9 – (− 6.9) and bias was 41.0 and 37.0, respectively. Of the included patients, 93.1% reported identical Foster scores between visits, resulting in an ...