Table 3 Summary table of literature analysis, PICOT question 1: influence of adherence to ICS therapy on asthma outcomes
Reference | Statement | Type of data source | Final level of evidence (see Fig. 1) | Possible impact on clinical practice (TF opinion) | Similar evidence available from RCTs |
|---|---|---|---|---|---|
Williams et al. [45] | Low adherence increases the risk of ED visits and oral steroid treatment | D-M | Moderate | Yes | No |
Taegtmeyer et al. [46] | Lower ACQ improvement associated with low adherence | PC-A | Moderate | Yes | No |
Laforest et al. [47] | Low adherence (MPR) associated with poorer control and more hospital contacts and oral steroid courses | PC-A | Moderate | Yes | No |
Laforest et al. [48] | Low adherence (MPR) increases the risk of oral steroid treatment and hospitalization | D-A | Moderate | Yes | No |
Sadatsafavi et al. [31] | Risk of asthma-related hospitalization lower with ICS-containing regimen than LABA alone | D-M | Moderate | Yes | No |
Risk of asthma-related hospitalization similar between ICS and ICS-LABA | D-M | Moderate | Yes | Noa | |
Risk of asthma-related hospitalization increases when ICS treatment is irregular | D-M | Moderate | Yes | No | |
Friedman et al. [43] | Adherence and SABA use are better with MF than FP DPIs, with no difference in other clinical outcomes | D-M | Moderate | No | No |
Campbell et al. [44] | Shifting drug costs to patients decreases adherence and impairs asthma outcomes | D | Moderate | Yes | No |
Tan et al. [38] | In adherent patients, ICS > LTRA | D + S | Moderate (D), low (S) | Yes | In part (pragmatic RCT) |
In non-adherent patients, ICS < LTRA | D + S | Moderate (D), low (S) | Yes | In part (pragmatic RCT) |