RT Journal Article
SR Electronic
T1 What Patients Call Their Inhalers Is Associated with “Asthma Attacks”
JF The Journal of the American Board of Family
                Medicine
JO J Am Board Fam Med
FD American Board of Family Medicine
SP 650
OP 661
DO 10.3122/jabfm.2022.220270R2
VO 36
IS 4
A1 Forth, Victoria E.
A1 Cardet, Juan Carlos
A1 Chang, Ku-Lang
A1 Ericson, Brianna
A1 Hurley, Laura P.
A1 Maher, Nancy E.
A1 Staton, Elizabeth W.
A1 Sosa, Bonnie Telón
A1 Israel, Elliot
A1 on behalf of the PREPARE investigators
YR 2023
UL http://www.jabfm.org/content/36/4/650.abstract
AB Background: Clinician-patient miscommunication contributes to worse asthma outcomes. What patients call their asthma inhalers and its relationship with asthma morbidity are unknown.Methods: Inhaler names were ascertained from Black and Latinx adults with moderate-severe asthma and categorized as “standard” if based on brand/generic name or inhaler type (i.e., controller vs. rescue) or “non-standard” for other terms (i.e., color, device type, e.g., “puffer,” or unique names). Clinical characteristics and asthma morbidity measures were evaluated at baseline: self-reported asthma exacerbations one year before enrollment (i.e., systemic corticosteroid bursts, emergency department (ED)/urgent care (UC) visits, or hospitalizations), and asthma control and quality of life. Multivariable regression models tested the relationship between non-standard names and asthma morbidity measures, with adjustments.Results: Forty-four percent (502/1150) of participants used non-standard inhaler names. These participants were more likely to be Black (p=0.006), from the Southeast (p<0.001), and have fewer years with asthma (p=0.012) relative to those who used standard names. Non-standard inhaler names was associated with an incidence rate ratio (IRR) of 1.29 (95% confidence interval [CI], 1.11-1.50, p=0.001; 1.8 vs. 1.5 events) for corticosteroid bursts for asthma, an IRR=1.43 (95% CI, 1.21-1.69, p<0.001; 1.9 vs. 1.4 events) for ED/UC visits for asthma, and an odds ratio=1.57 (95% CI, 1.12-2.18, p=0.008; 0.5 vs. 0.3 events) for asthma hospitalizations after adjustment.Conclusions: Patients who use non-standard names for asthma inhalers experience increased asthma morbidity. Ascertaining what patients call their inhalers may be a quick method to identify those at higher risk of poor outcomes.