ABS004: The concept, prevalence and consequences of low tolerance to ICS in asthma

Abstract

Introduction:

The concept of low tolerance to ICS can be extended beyond the experience of side effects to include conceptual barriers such as doubts about personal need for ICS, and concerns about ICS.

Aims and objectives:

To assess the prevalence of low tolerance to ICS and consequences in terms of ICS adherence and asthma control.

Subjects and methods:

2372 patients managed in primary care at steps 2 and 3 of the asthma guidelines who participated in the Asthma Control, Concordance and Tolerance (ACCT) initiative and completed the Minimum Asthma Assessment Tool (MAAT) [1] and Asthma Control Questionnaire (ACQ) [2]. ICS adherence was measured by validated self-report [1], cross-checked against prescription redemption data.

Results:

Prevalence of low tolerance to ICS Experiential – Patients attributed bothersome symptoms to ICS: cough (31.5%), hoarse voice (20.6%), sore mouth (17.3%), weight gain (12%), bruising (9.4%), dental decay (9.3%), and oral thrush (8.8%). Conceptual- 21.4% reported concerns about ICS (e.g. long term effects, dependency, difficult to use and inconvenient) and 17.8% had doubts about their need for ICS.

Consequences of low tolerance Low adherence to ICS (38.3%) was associated with the attribution of bothersome symptoms to ICS (t = 3.06; p< 0.005), doubts about personal need for ICS (t = 20.83; p< 0.001) and ICS concerns (t = 7.10; p < 0.001). ICS non-adherence was related to poor asthma control (ACQ t = 3.83; p< 0.001).

Conclusions:

Experiential and conceptual indicators of low tolerance to ICS were prevalent and associated with low adherence to ICS and hence asthma control.

Conflict of interest and funding

ACCT is supported by an unrestricted educational grant from ALTANA Pharma.