Patterns and Determinants of Compliance with Inhaled Steroids in Adults with Asthma
Bibliographic record
Abstract
BACKGROUND: Patient compliance with inhaled corticosteroids (ICS) in asthma is considered to be suboptimal. OBJECTIVES: To describe the patterns of compliance with ICS and identify factors determining the compliance to ICS in adults with asthma. METHODS: Based on a review of the literature and interviews with asthmatic patients who require the regular use of ICS, potential determinants of compliance to ICS were identified. Questionnaires related to these determinants were then administered to a cohort of patients from three subspecialty clinics, including two from university-affiliated centres. Patients with mild-to-moderate asthma who were 15 years of age and older and required (from the physician's point of view) ICS as maintenance medication because of persistent asthma were included in the study. Patients were followed for a period of 12 weeks. Compliance was measured using electronic devices. RESULTS: Data from 124 patients (51 men; mean age 47+/-15 years; mean prescribed daily dose of ICS [fluticasone propionate] 643+/-385 microg) were analyzed. On average, the patients took 72+/-24% of their prescription. Four patterns of compliance were observed and are described: 1A -- regular compliance (n = 29); 1B -- irregular compliance (n = 37); 2A -- regular noncompliance (n = 24); and 2B -- irregular noncompliance (n = 34). Among the potential predictors of noncompliance, age was the only significant predictor (compliance increased with increasing age). There was no difference in asthma control between compliant and noncompliant patients. CONCLUSION: Compliance to ICS in patients with asthma is often suboptimal and difficult to predict. The observations suggest that some asthmatics may be overtreated with ICS.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.007 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".