Evidence map›Paper›PMID 28619778›Full record

Trial reportBMJ open2017

In patients with severe uncontrolled asthma, does knowledge of adherence and inhaler technique using electronic monitoring improve clinical decision making? A protocol for a randomised controlled trial.

Matshediso C Mokoka, Lorna Lombard, Elaine M MacHale, Joanne Walsh, Breda Cushen, Imran Sulaiman, Damien Mc Carthy, Fiona Boland, Frank Doyle, Eoin Hunt and 9 more

Registry-linked trialOpen access · goldAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMJ open, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02307669 (A Study on Inhaler Adherence to Improve Poor Asthma Control), which is not on this map. Cited by 14 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
14citing papers in PubMed, 1 pooled it
2.3field-weighted citation impact, top 12% 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.

NCT02307669 naunknown statusnot on this map

A Study on Inhaler Adherence to Improve Poor Asthma Control

TypeinterventionalSponsorBeaumont HospitalRan2015 to 2020Enrolled220ConditionsAsthmaArmsINCA feedback, Usual Care
3 · Its place in the literature

Who cites it

14 citing papers in PubMed, 1 synthesis or guideline pooled it, 31 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Article
  4. Review
  5. Review
  6. Assessing adherence to inhaled therapies in asthma and the emergence of electronic monitoring devices.European respiratory review : an official journal of the European Respiratory Society · 2022
    Review
  7. Article
  8. Review
  9. Review
  10. Observational
  11. Article
  12. Article
  13. Article
  14. Review
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

19 authors at 9 institutions in 4 countries.

Matshediso C MokokaClinical Research Centre, Smurfit Building Beaumont Hospital, RCSI, Dublin, Ireland.
Lorna LombardClinical Research Centre, Smurfit Building Beaumont Hospital, RCSI, Dublin, Ireland.
Elaine M MacHaleClinical Research Centre, Smurfit Building Beaumont Hospital, RCSI, Dublin, Ireland.
Joanne WalshClinical Research Centre, Smurfit Building Beaumont Hospital, RCSI, Dublin, Ireland.
Breda CushenClinical Research Centre, Smurfit Building Beaumont Hospital, RCSI, Dublin, Ireland.
Imran SulaimanClinical Research Centre, Smurfit Building Beaumont Hospital, RCSI, Dublin, Ireland.
Damien Mc CarthyClinical Research Centre, Smurfit Building Beaumont Hospital, RCSI, Dublin, Ireland.
Fiona BolandDivision of Population Health Sciences, RCSI, Dublin, Ireland.
Frank DoyleDivision of Population Health Sciences, RCSI, Dublin, Ireland.
Eoin HuntDepartment of Respiratory Medicine, University Hospital Cork and Clinical Research Facility, University College Cork, Cork, Ireland.
Desmond M MurphyDepartment of Respiratory Medicine, University Hospital Cork and Clinical Research Facility, University College Cork, Cork, Ireland.
John FaulDepartment of Respiratory Medicine, Connolly University Hospital, Dublin, Ireland.
Marcus ButlerDepartment of Respiratory Medicine, St Vincent's Hospital Dublin, Dublin, Ireland.
Kathy HetheringtonCentre for Experimental Medicine, School of Medicine, Dentistry and Biomedical Sciences, Queens University, Belfast, UK.
J Mark FitzGeraldRespiratory Medicine Division, University of British Colombia, Vancouver, Canada.
Job Fm van BovenUnit of Pharmaco-epidemiology & Pharmaco-economics, Department of Pharmacy, University of Groningen, Groningen, The Netherlands.
Liam G HeaneyCentre for Experimental Medicine, School of Medicine, Dentistry and Biomedical Sciences, Queens University, Belfast, UK.
Richard B ReillyTrinity Centre for Bioengineering, Trinity College, University of Dublin, Dublin, Ireland.
Richard W CostelloDepartment of Medicine, RCSI, Dublin, Ireland.
Beaumont Hospital · IERoyal College of Surgeons in Ireland · IECork University Hospital · IEQueen's University Belfast · GBConnolly Hospital Blanchardstown · IESt. Vincent's University Hospital · IETrinity College Dublin · IEUniversity of British Columbia · CAUniversity of Groningen · NL

Funding

Medical Research Council MR/M016579/1
6 · The paper itself

Abstract

introductionMany patients with asthma remain poorly controlled despite the use of inhaled corticosteroids and long-acting beta agonists. Poor control may arise from inadequate adherence, incorrect inhaler technique or because the condition is refractory. Without having an objective assessment of adherence, clinicians may inadvertently add extra medication instead of addressing adherence. This study aims to assess if incorporating objectively recorded adherence from the Inhaler Compliance Assessment (INCA) device and lung function into clinical decision making provides more cost-effective prescribing and improves outcomes. METHODS AND ANALYSIS: This prospective, randomised, multicentre study will compare the impact of using information on adherence to influence asthma treatment. Patients with severe uncontrolled asthma will be included. Data on adherence, inhaler technique and electronically recorded peak expiratory flow rate will be used to promote adherence and guide a clinical decision protocol to guide management in the active group. The control group will receive standard inhaler and adherence education. Medications will be adjusted using a protocol based on Global Initiativefor Asthma (GINA) recommendations. The primary outcome is the between-group difference in the proportion of patients who have refractory disease and are prescribed appropriate medications at the end of 32 weeks. A co-primary outcome is the difference between groups in the rate of adherence to salmeterol/fluticasone inhaler over the last 12 weeks. Secondary outcomes include changes in symptoms, lung function, type-2 cytokine biomarkers and clinical outcomes between both groups. Cost-effectiveness and cost-utility analyses of the INCA device intervention will be performed. The economic impact of a national implementation of the INCA-SUN programme will be evaluated. ETHICS AND DISSEMINATION: The results of the study will be published as a manuscript in peer-reviewed journals. The study has been approved by the ethics committees in the five participating hospitals.

trial registrationNCT02307669; Pre-results.

Indexed as

Clinical Decision-MakingDrug MonitoringNebulizers and VaporizersAdministration, InhalationAdrenal Cortex HormonesAdultAsthmaBronchodilator AgentsDisease ProgressionFemaleHealth Knowledge, Attitudes, PracticeHumansIrelandMaleMedication AdherencePatient Education as TopicAdrenal Cortex HormonesBronchodilator AgentsadherenceINCA electronic monitorinhaler technique.randomisedcontrolled trialsevere uncontrolled asthma

Identifiers

PMID28619778
PMCPMC5734350
OpenAlexW2626252743

What OpenQuestion holds

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LicenceCC BY-NC
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.