Browsing by Author "Almutairi, Mohammed Ghazi M"

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DETECTION AND MANAGEMENT OF MEDICATION NON-ADHERENCE IN SEVERE ASTHMA
(Saudi Digital Library, 2024-09-27) Almutairi, Mohammed Ghazi M; Marriott, John and Mansur, Adel and Jalal, Zahraa
Evidence exists for the positive role of a multidisciplinary team (MDT) approach and adherence monitoring technologies, particularly electronic monitoring devices (EMDs) in detecting and managing medication non-adherence in severe asthma. Although non-adherence management is persistently challenging depending on attitudes toward medication and the underlying non-adherence causes are not fully understood, higher adherence rates led to clinical improvement and enhanced quality of life and non-adherence rates were associated with a negative response to advanced treatment (mepolizumab) and raised inflammatory biomarkers (FeNO levels). Future non-adherence management strategies offer an opportunity for a cost-effective care plan to reduce asthma exacerbations and enhance the quality of life for adult patients with severe asthma. After examining the ICS non-adherence effect on biologic therapy escalation and response to mepolizumab treatment as an example (Chapter 2), this thesis explored the effectiveness of various electronic monitoring technologies on monitoring adherence and asthma clinical outcomes (Chapter 3). Non-adherence detection is an essential step. However, non-adherence management remains challenging and demands an MDT approach established on objective data to address patient attitudes and effectively enhance non-adherence management and clinical outcomes (Chapter 4). Additionally, affordable adherence optimizing strategies by detecting and managing non-adherence can offer an opportunity to become part of future severe asthma care plans (Chapter 5). The following findings confirm the impact of non-adherence on severe asthma management outcomes for those who need escalation to biological therapies (such as mepolizumab). Electronic monitoring technology has shown a positive effect on monitoring adherence and improving clinical outcomes. The MDT approach engagement with electronic technology has improved adherence and clinical outcomes. Furthermore, using a newer electronically connected inhaler system (CIS) is cost-effective in preventing asthma exacerbation and enhancing the quality of life compared to standard care among adult severe asthma patients. Further research is necessary to investigate the impact of non-adherence on alternative biological agents and to validate different MDT approaches using adherence monitoring technologies across various healthcare settings among adult patients with severe asthma.
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