Evidence map›Paper›PMID 37088377›Full record

ArticleThe journal of allergy and clinical immunology. In practice2023

Is Once Versus Twice Daily Dosing Better for Adherence in Asthma and Chronic Obstructive Pulmonary Disease?

Heather De Keyser, Vy Vuong, Leanne Kaye, William C Anderson, Stanley Szefler, David A Stempel

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The journal of allergy and clinical immunology. In practice, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.

0numbers the graph read from it
0cells of the map it votes in
17citing papers in PubMed
7.5field-weighted citation impact, top 2% 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

17 citing papers in PubMed, 29 citations in OpenAlex.

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  12. Is Disease Stability an Attainable Chronic Obstructive Pulmonary Disease Treatment Goal?American journal of respiratory and critical care medicine · 2025
    Review
  13. Review
  14. Article
  15. Factors Affecting Adherence in Allergic Disorders and Strategies for Improvement.The journal of allergy and clinical immunology. In practice · 2024
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  16. Article
  17. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors at 2 institutions in 2 countries.

Heather De KeyserBreathing Institute, Children's Hospital Colorado and Adult and Child Center for Outcomes Research and Dissemination Science, University of Colorado, Aurora, Colo. Electronic address: Heather.DeKeyser@childrenscolorado.org.
Vy VuongMedical Affairs, ResMed Science Center, San Francisco, Calif.
Leanne KayeMedical Affairs, ResMed Science Center, San Francisco, Calif.
William C AndersonAllergy and Immunology Section, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, Colo.
Stanley SzeflerBreathing Institute, Children's Hospital Colorado and Adult and Child Center for Outcomes Research and Dissemination Science, University of Colorado, Aurora, Colo.
David A StempelClinical and Medical Affairs, Propeller Health, Madison, Wis.
University of Colorado Denver · USResMed (Australia) · AU

Funding

Treatment Phenotypes for Adolescents with AsthmaK23HL146791 · NHLBI · UNIVERSITY OF COLORADO DENVER · PI DE KEYSER, HEATHER · 2020 to 2024
$837k
NHLBI NIH HHS K23 HL146791
6 · The paper itself

Abstract

backgroundPatients with asthma and chronic obstructive pulmonary disease (COPD) may be prescribed once- or twice-daily dosing of controller inhalers.

objectiveTo assess differences in controller adherence by dosing schedule and age.

methodsElectronic medication monitors (EMMs) captured the date and time of inhaler actuations over 90 days in patients using the Propeller Health platform. Prescribed inhaler schedule was self-reported. Once- versus twice-daily schedule comparisons were assessed retrospectively using regressions adjusting for age.

resultsA total of 6294 patients with asthma and 1791 patients with COPD were included. On average, once-daily users had significantly higher median (interquartile range [IQR]) daily adherence than twice-daily users (asthma: 63.3 [IQR: 31.1, 86.7]% vs 50.3 [IQR: 21.1, 78.3]%, P < .001; COPD: 83.3 [IQR: 57.2, 95.6]% vs 64.7 [IQR: 32.8, 88.9]%, P < .001). This pattern persisted in all age groups, with the exception of 4- to 17-year-olds in asthma. The lowest adherence was in the young adult population (18- to 29-year-olds). The percentage of patients who achieved ≥80% adherence was significantly higher among once- versus twice-daily users in asthma (34.3% vs 23.6%, P < .001) and COPD (54.8% vs 38.6%, P < .001). The adjusted odds of once- versus twice-daily users achieving ≥80% adherence was 1.36 (95% confidence interval: 1.19-1.56, P < .001) in asthma and 1.73 (95% confidence interval: 1.38-2.17, P < .001) in COPD. Most once-daily patients with COPD took their medication in the morning versus at night; there was no difference in morning versus afternoon/evening administration in all other asthma and COPD groups.

conclusionPatients with asthma and COPD who were prescribed once-daily versus twice-daily medications were more likely to adhere to their inhalers. Patients with COPD had higher adherence than those with asthma, possibly reflecting, in part, the older cohort age. The effect of greater adherence on exacerbations is a topic for future analysis.

Indexed as

AsthmaPulmonary Disease, Chronic ObstructiveAdministration, InhalationBronchodilator AgentsHumansMedication AdherenceNebulizers and VaporizersRetrospective StudiesYoung AdultBronchodilator AgentsAdherenceAsthmaCOPDDigital healthElectronic medication monitoring

Identifiers

PMID37088377
PMCPMC10330551
OpenAlexW4366606971

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

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.