ReviewThe Journal of asthma : official journal of the Association for the Care of Asthma2013
Improving asthma management: the case for mandatory inclusion of dose counters on all rescue bronchodilators.
Review in The Journal of asthma : official journal of the Association for the Care of Asthma, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
What it found
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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.
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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.
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Who cites it
17 citing papers in PubMed, 45 citations in OpenAlex.
- How do patients determine when their inhaler is empty? Insights from an analysis of returned inhalers and a patient survey.BMJ open respiratory research · 2024Article
- Inhalation Devices in 7- to 15-Year-Old Children with Asthma - A Patient Preference Study.Patient preference and adherence · 2023Article
- Article
- Interleukin‑27 ameliorates allergic asthma by alleviating the lung Th2 inflammatory environment.International journal of molecular medicine · 2022Article
- An investigation into hospital prescribers' knowledge and confidence to provide high-quality, sustainable respiratory care.Future healthcare journal · 2021Article
- IL‑27 suppresses airway inflammation, hyperresponsiveness and remodeling via the STAT1 and STAT3 pathways in mice with allergic asthma.International journal of molecular medicine · 2020Article
- Sustainability in Inhaled Drug Delivery.Pharmaceutical medicine · 2020Review
- Article
- Outcome of illustrated information leaflet on correct usage of asthma-metered dose inhaler.African journal of primary health care & family medicine · 2019Article
- Identifying Critical Errors: Addressing Inhaler Technique in the Context of Asthma Management.Pulmonary therapy · 2018Review
- Real-world health care utilization in asthma patients using albuterol sulfate inhalation aerosol (ProAirJournal of asthma and allergy · 2017Article
- Historical cohort study examining comparative effectiveness of albuterol inhalers with and without integrated dose counter for patients with asthma or chronic obstructive pulmonary disease.Journal of asthma and allergy · 2016Article
- Advances in device and formulation technologies for pulmonary drug delivery.AAPS PharmSciTech · 2014Review
- Neuroimmune semaphorin 4A as a drug and drug target for asthma.International immunopharmacology · 2013Article
- Assessing the use of MDI among asthmatic patients in Saudi Arabia.Pharmacy practiceArticle
- Emergency department visits for acute asthma by adults who ran out of their inhaled medications.Allergy and asthma proceedingsArticle
- Patient perspectives on the environmental impact of inhalers: A survey in British Columbia.Canadian pharmacists journal : CPJ = Revue des pharmaciens du Canada : RPCArticle
Corrections and comments
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Authors and funding
2 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAsthma remains a serious global health challenge. Poor control of asthma symptoms is due in part to incorrect use of oral inhaler devices that deliver asthma medications, such as poor inhalation technique or use of a metered dose inhaler (MDI) after the recommended number of doses is expelled.
objectiveTo review published research on the potential for patients to overestimate or underestimate the amount of asthma rescue medication in MDIs without integrated dose-counting mechanisms.
methodsWe searched PubMed and EMBASE using search terms "dose counter and asthma" and "dose counter and metered dose inhaler" for English language publications up to July, 2012, with a manual search of references from relevant articles.
resultsUp to 40% of patients believe they are taking their asthma medication when they actually are activating an empty or nearly empty MDI. Device design makes it impossible for an MDI to cease delivering drug doses at an exact point, and the number of actuations in an MDI may be twice the nominal number of recommended medication doses. Once the recommended number of medication doses is expelled, remaining actuations deliver decreasing concentrations of active medication and increasing concentrations of propellants and excipients. This phenomenon, called "tail-off," is particularly problematic when medications are formulated as suspensions, as are rescue medications to control acute bronchospasm. Reliable inhalation of rescue medication could reduce asthma-related morbidity.
conclusionBy helping to ensure that patients receive accurate metered doses of asthma rescue medication to relieve bronchoconstriction, dose counters may help to improve asthma management.
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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.