1. Patient-physician discordance in assessment of adherence to inhaled controller medication: a cross-sectional analysis of two cohorts
- Author
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Ricardo M Fernandes, Luís Taborda-Barata, Joana Carvalho, Georgeta Oliveira, Diana Bordalo, Marta Alves, Carlos Alves, Cristina Jácome, Ana Margarida Pereira, Rute Almeida, Manuel Ferreira-Magalhaes, Mariana Couto, Luís Araujo, Mariana Pereira, Magna Alves Correia, Cláudia Chaves Loureiro, Maria Joana Catarata, Lília Maia Santos, João Pereira, Bárbara Ramos, Cristina Lopes, Ana Mendes, José Carlos Cidrais Rodrigues, Ana Paula Aguiar, Ivete Afonso, Ana Arrobas, José Coutinho Costa, Joana Dias, Ana Todo Bom, João Azevedo, Carmelita Ribeiro, Paula Leiria Pinto, Nuno Neuparth, Ana Palhinha, João Gaspar Marques, Nicole Pinto, Pedro Martins, Filipa Todo Bom, Maria Alvarenga Santos, Alberto Gomes Costa, Armandina Silva Neto, Marta Santalha, Carlos Lozoya, Natacha Santos, Diana Silva, Maria João Vasconcelos, Célia Carvalhal, Maria Fernanda Teixeira, Rodrigo Rodrigues Alves, Ana Sofia Moreira, Cláudia Sofia Pinto, Pedro Morais Silva, Raquel Câmara, Didina Coelho, Rosário Ferreira, Fernando Menezes, Ricardo Gomes, Maria José Calix, Ana Marques, João Cardoso, Madalena Emiliano, Rita Gerardo, Carlos Nunes, Rita Câmara, José Alberto Ferreira, Aurora Carvalho, Paulo Freitas, Ricardo Correia, and Joao A Fonseca
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Medicine - Abstract
Objective We aimed to compare patient’s and physician’s ratings of inhaled medication adherence and to identify predictors of patient-physician discordance.Design Baseline data from two prospective multicentre observational studies.Setting 29 allergy, pulmonology and paediatric secondary care outpatient clinics in Portugal.Participants 395 patients (≥13 years old) with persistent asthma.Measures Data on demographics, patient-physician relationship, upper airway control, asthma control, asthma treatment, forced expiratory volume in one second (FEV1) and healthcare use were collected. Patients and physicians independently assessed adherence to inhaled controller medication during the previous week using a 100 mm Visual Analogue Scale (VAS). Discordance was defined as classification in distinct VAS categories (low 0–50; medium 51–80; high 81–100) or as an absolute difference in VAS scores ≥10 mm. Correlation between patients’ and physicians’ VAS scores/categories was explored. A multinomial logistic regression identified the predictors of physician overestimation and underestimation.Results High inhaler adherence was reported both by patients (median (percentile 25 to percentile 75) 85 (65–95) mm; 53% VAS>80) and by physicians (84 (68–95) mm; 53% VAS>80). Correlation between patient and physician VAS scores was moderate (rs=0.580; p
- Published
- 2019
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