Morning use of daily controller medications for asthma, COPD linked with higher adherence

Morning use of once-daily controller medications for asthma and COPD was common and associated with higher adherence than afternoon and evening use, according to results presented at the American Thoracic Society International Conference.

Leanne Kaye, PhD, MPH, RD, senior behavioral scientist at ResMed, and colleagues conducted an analysis of 3,455 participants enrolled in Propeller Health, an FDA-cleared digital platform with an electronic sensor that passively tracks date and time of inhaler use, from 2016 to 2019. All participants had self-reported asthma or COPD, were using at least one controller inhaler plus the electronic sensor and the first 90 days of data were available for analysis.

Participants were categorized as regular a.m. (midnight to 11:59 am) or p.m. (noon to 11:59 p.m.) users based on the maximum number of controller medication uses during each period.

In the cohort, 2,108 (61%) participants had asthma (mean age, 41.4 years; mean medication adherence, 60.1%) and 1,347 (39%) participants had COPD (mean age, 62 years; mean medication adherence, 75%).

The most common time of controller medication use was during the morning, in 68% of participants with asthma and 79% with COPD. Peak morning medication controller use was approximately 7 a.m. for those with asthma and 9 a.m. for those with COPD, according to the presentation.

There were no clear peaks in controller medication use during afternoon and evening hours for patients with COPD. For those with asthma, peak afternoon and evening hours were from 7 p.m. to 10 p.m.

Researchers observed significantly higher controller medication adherence among participants with asthma (62.5% vs. 54.5%) and/or COPD (77.6% vs. 64.7%) who used their medications during morning hours compared with afternoon and evening hours (P < .001 for all).

The absolute adherence was 6% lower among patients with asthma and 13% lower among patients with COPD who used their inhalers during afternoon and evening hours compared with those who used their inhalers during morning hours.

“Morning use yielded higher adherence and may be recommended,” Kaye said. “Shared decision-making should be considered when scheduling time of controller use.”

Reference:

Gondalia R, et al. Am J Respir Crit Care Med. 2021;doi:10.1164/ajrccm-conference.203.1.