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Yu Nakanishi,1 Hiroshi Iwamoto,1 Shintaro Miyamoto,1 Satoshi Nakao,1 Naoko Higaki,1 Kakuhiro Yamaguchi,1 Shinjiro Sakamoto,1 Yasushi Horimasu,1 Takeshi Masuda,1 Naoko Matsumoto,2 Taku Nakashima,1 Yojiro Onari,3 Kazunori Fujitaka,1 Yoshinori Haruta,4 Hironobu Hamada,5 Soichiro Hozawa,6 Noboru Hattori1 1Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan; 2Department of Respiratory Medicine, Hiroshima Red Cross Hospital & Atomic-Bomb Survivors Hospital, Hiroshima, Japan; 3Department of Respiratory Medicine, Hiroshima Mazda Hospital, Hiroshima, Japan; 4Haruta Respiratory Clinic, Hiroshima, Japan; 5Department of Physical Analysis and Therapeutic Sciences, Graduate School of Biomedical and Health Sciences Hiroshima University, Hiroshima, Japan; 6Hiroshima Allergy and Respiratory Clinic, Hiroshima, JapanCorrespondence: Hiroshi Iwamoto, Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan, Tel +81-82-257-5196, Email iwamotohiroshig@gmail.comPurpose: Asthma guidelines recommend considering the patient preference to optimize medication choices. Patient preference for inhaler medication may affect asthma outcomes, but evidence regarding this is lacking. This study investigated the associations between patient preference for inhaler medications and asthma outcomes.Patients and Methods: A multicenter questionnaire survey was conducted among 351 adult patients with asthma treated with regular inhaled corticosteroids. Agreement between patients’ preferences and current medication was evaluated using two questions: matched preference was defined as patients answering that the current inhaler medication was the most preferred treatment and they were satisfied with it. Mismatched preference was defined as when patients reported that the current inhaler medication was not the most preferred treatment and/or they were not satisfied with it. We investigated the factors associated with patient preference for asthma inhaler medications.Results: In total, 269 (76.6%) patients were classified into the matched preference group and 82 (23.4%) patients into the mismatched preference group. Multivariate analyses showed that matched preference was independently associated with higher asthma control test scores (P< 0.001), fewer exacerbations (P=0.009), less regular oral corticosteroid use (P=0.009), and better inhaler adherence (P=0.006) than the mismatched preference group. In subgroup analysis, younger age was associated with matched preference in patients using dry powder inhalers but not in those using pressurized metered dose inhalers.Conclusion: The use of preference-matched inhaler medication was associated with better asthma outcomes. Evaluation of patients’ preference for inhaler medication might provide useful information for individualized treatment with asthma inhaler medications.Keywords: patient preference, asthma control, inhaled corticosteroids, inhaler adherence, shared decision-making |
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