Nonstandard inhaler names associated with worse asthma outcomes

Effective communication between physicians and patients is crucial for positive patient outcomes. The use of inaccurate terminology for medication and medical devices may lead to worse disease management. In this article, Forth et al. analyzed data made available last month through the Patient-Centered Outcomes Data Repository (PCODR) in the study, Patient Empowered Strategy to Reduce Asthma Morbidity in Highly Impacted Populations (PESRAMHIP), United States, 2017-2021, to determine if the use of nonstandard inhaler names is associated with worse control of asthma. In a randomized clinical trial, PESRAMHIP recruited 1,201 African American/Black and Hispanic/Latinx adults with moderate-to-severe asthma to either: use a patient-activated, reliever-triggered inhaled corticosteroid strategy (PARTICS) plus usual care from their provider, or to continue with usual provider care, alone. The study specifically targeted African-American, Hispanic, and Latino adult asthma patients, as these populations experience worse outcomes for asthma compared to White populations. Participants were required to attend one in-person visit for consent, and to complete 15 monthly questionnaires that ultimately measured their rates of severe asthma exacerbations and quality of life.

For this article, Forth et al. conducted an ancillary study, in which they discovered that patients in the PERAMHIP study who used nonstandard names for rescue and controller inhalers were more likely to experience “increased odds of corticosteroid bursts for asthma, asthma ED/UC visits, and hospitalizations.” Of the 1,201 participants in the PESRAMHIP study who had included legible rescue and controller inhaler names in their questionnaire responses, 502 used a nonstandard name for their inhaler. Some called it by its color or its delivery method (for example, “puffer” or “disc”), while a smaller portion had a completely unique name for the inhaler, such as “Bob,” “Breath of life,” and “Keep me alive.” The authors used the Asthma Control Test (ACT) to assess non-standard name use and complications with asthma. The ACT scores one’s control of asthma symptoms on a scale of 5 to 25, with lower scores indicating poorly controlled asthma. Forth et al. “found that relative to use of standard inhaler names, use of nonstandard names associated with -0.58 lower ACT scores.” Understanding the connection between nonstandard inhaler names and poor asthma outcomes may help physicians by acting “as a very simple and quick way to identify patients at risk of greater asthma morbidity in clinical settings.”

The PESRAMHIP investigators have published in several journals on various findings from the project, including articles in The New England Journal of Medicine(PDF) and the Journal of Allergy and Clinical Immunology. To view all publications resulting from this study to date, visit the Data-related Publications tab on the PESRAMHIP study homepage.