Evidence map›Paper›PMID 22019090›Full record

ArticleThe Journal of allergy and clinical immunology2011

Quantifying the proportion of severe asthma exacerbations attributable to inhaled corticosteroid nonadherence.

L Keoki Williams, Edward L Peterson, Karen Wells, Brian K Ahmedani, Rajesh Kumar, Esteban G Burchard, Vimal K Chowdhry, David Favro, David E Lanfear, Manel Pladevall

2 registry-linked trialsAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The Journal of allergy and clinical immunology, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 147 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
147citing papers in PubMed, 8 pooled it
12.8field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03239431 unknown statusnot on this mapstarted 2017, after this paper: background citation

A 3 Year Longitudinal Study of the Level of Asthma Control and Treatment of Asthma Patients in Hong Kong

Typeobservational_patient_registrySponsorChinese University of Hong KongRan2017 to 2022Enrolled400ConditionsAsthmaArmsasthmatic exacerbation
NCT04479501 completednot on this mapstarted 2017, after this paper: background citation

Retrospective Review on Patients With Recurrent Asthmatic Attacks Requiring Hospitalizations

TypeobservationalSponsorChinese University of Hong KongRan2017 to 2019Enrolled2,280ConditionsAsthmaArmsAsthma exacerbation related hospitalization
3 · Its place in the literature

Who cites it

147 citing papers in PubMed, 8 syntheses or guidelines pooled it, 353 citations in OpenAlex.

  1. Remote monitoring in asthma: a systematic review.European respiratory review : an official journal of the European Respiratory Society · 2025
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  7. Corticosteroid plus βRespiratory research · 2017
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  12. Implementing Health Care Technology Research into Practice to Improve Adult Asthma Management.The journal of allergy and clinical immunology. In practice · 2019
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  19. Asthma medication adherence: the role of God and other health locus of control factors.Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology · 2013
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87 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 3 institutions in 1 country.

L Keoki WilliamsCenter for Health Services Research, Henry Ford Health System, Detroit, MI 48202, USA. kwillia5@hfhs.org
Edward L Peterson
Karen Wells
Brian K Ahmedani
Rajesh Kumar
Esteban G Burchard
Vimal K Chowdhry
David Favro
David E Lanfear
Manel Pladevall
Henry Ford Health System · USLurie Children's Hospital · USUniversity of California, San Francisco · US

Funding

Gene-environments and Admixture in Latino Asthmatics (GALA 2)R01ES015794 · NIEHS · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI BURCHARD, ESTEBAN GONZALEZ · 2008 to 2012
$5.4M
PHARMACOGENOMICS OF INHALED CORTICOSTEROID RESPONSIVENESS IN PATIENTS WITH ASTHMAR01AI079139 · NIAID · HENRY FORD HEALTH SYSTEM · PI WILLIAMS, KEOKI · 2009 to 2013
$3.9M
Whole Genome Analyses for Asthma in Latino PopulationsR01HL088133 · NHLBI · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI BURCHARD, ESTEBAN GONZALEZ · 2008 to 2012
$3.8M
Mechanism of Endotoxin's Effect On Allergy RiskR01AI061774 · NIAID · HENRY FORD HEALTH SYSTEM · PI WILLIAMS, KEOKI · 2004 to 2008
$2.9M
VALIDATION OF ADHERENCE DATA--USE IN CLINICAL PRACTICER01DK064695 · NIDDK · HENRY FORD HEALTH SYSTEM · PI WILLIAMS, KEOKI · 2003 to 2010
$2.7M
Case-control Association Studies and Genetic ConfoundingR01HL078885 · NHLBI · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI BURCHARD, ESTEBAN GONZALEZ · 2005 to 2009
$1.9M
USING INFORMATION TECHNOLOGY TO IMPROVE ASTHMA ADHERENCER01HL079055 · NHLBI · HENRY FORD HEALTH SYSTEM · PI WILLIAMS, KEOKI · 2005 to 2008
$1.4M
Role of Prenatal Factors and Gene-Environment Interactions in Recurrent WheezingK23HL093023 · NHLBI · LURIE CHILDREN'S HOSPITAL OF CHICAGO · PI KUMAR, RAJESH · 2008 to 2012
$672k
NHLBI NIH HHS K23 HL093023NHLBI NIH HHS K23HL093023-01NHLBI NIH HHS R01 HL078885NHLBI NIH HHS R01HL078885NHLBI NIH HHS R01 HL079055NHLBI NIH HHS R01HL079055NHLBI NIH HHS R01 HL088133NHLBI NIH HHS R01HL088133NIAID NIH HHS R01 AI061774NIAID NIH HHS R01AI061774NIAID NIH HHS R01 AI079139NIAID NIH HHS R01AI079139NIDDK NIH HHS R01 DK064695NIDDK NIH HHS R01DK064695NIEHS NIH HHS R01 ES015794
6 · The paper itself

Abstract

backgroundAsthma is an inflammatory condition often punctuated by episodic symptomatic worsening, and accordingly, patients with asthma might have waxing and waning adherence to controller therapy.

objectiveWe sought to measure changes in inhaled corticosteroid (ICS) adherence over time and to estimate the effect of this changing pattern of use on asthma exacerbations.

methodsICS adherence was estimated from electronic prescription and fill information for 298 participants in the Study of Asthma Phenotypes and Pharmacogenomic Interactions by Race-Ethnicity. For each patient, we calculated a moving average of ICS adherence for each day of follow-up. Asthma exacerbations were defined as the need for oral corticosteroids, an asthma-related emergency department visit, or an asthma-related hospitalization. Proportional hazard models were used to assess the relationship between ICS medication adherence and asthma exacerbations.

resultsAdherence to ICS medications began to increase before the first asthma exacerbation and continued afterward. Adherence was associated with a reduction in exacerbations but was only statistically significant among patients whose adherence was greater than 75% of the prescribed dose (hazard ratio, 0.61; 95% CI, 0.41-0.90) when compared with patients whose adherence was 25% or less. This pattern was largely confined to patients whose asthma was not well controlled initially. An estimated 24% of asthma exacerbations were attributable to ICS medication nonadherence.

conclusionsICS adherence varies in the time period leading up to and after an asthma exacerbation, and nonadherence likely contributes to a large number of these exacerbations. High levels of adherence are likely required to prevent these events.

Indexed as

Drug MonitoringAdministration, InhalationAdrenal Cortex HormonesAdultAnti-Asthmatic AgentsAsthmaEmergency Service, HospitalFemaleHospitalizationHumansMaleAdrenal Cortex HormonesAnti-Asthmatic Agents

Identifiers

PMID22019090
PMCPMC3229671
OpenAlexW2062940257

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.