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Potential negative consequences of non-consented switch of inhaled medications and devices in asthma patients

BackgroundAsthma requires individually tailored and careful management to control and prevent symptoms and exacerbations. Selection of the most appropriate treatment is dependent on both the choice of drugs and inhaler device; however, financial pressures may result in patients being switched to alt...

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Autores principales: Björnsdóttir, U S, Gizurarson, S, Sabale, U
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Blackwell Publishing Ltd 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3902990/
https://www.ncbi.nlm.nih.gov/pubmed/23773278
http://dx.doi.org/10.1111/ijcp.12202
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author Björnsdóttir, U S
Gizurarson, S
Sabale, U
author_facet Björnsdóttir, U S
Gizurarson, S
Sabale, U
author_sort Björnsdóttir, U S
collection PubMed
description BackgroundAsthma requires individually tailored and careful management to control and prevent symptoms and exacerbations. Selection of the most appropriate treatment is dependent on both the choice of drugs and inhaler device; however, financial pressures may result in patients being switched to alternative medications and devices in an attempt to reduce costs. AimThis review aimed to examine the published literature in order to ascertain whether switching a patient’s asthma medications or device negatively impacts clinical and economic outcomes. Materials and methodsA literature search of MEDLINE (2001–13 September 2011) was conducted to identify English-language articles focused on the direct impact of switching medications and inhaler devices and switching from fixed-dose combination to monocomponent therapy via separate inhalers in patients with asthma; the indirect impacts of switching were also assessed. ResultsEvidence showed that non-consented switching of medications and inhalers in patients with asthma can be associated with a range of negative outcomes, at both individual and organisational levels. Factors that reduce adherence may lead to compromised symptom control resulting in increased healthcare resource utilisation and poorer patient quality of life. DiscussionThe consequences of a non-consented switch should be weighed carefully against arguments supporting an inhaler switch without the patient’s consent for non-medical/budgetary reasons, such as potential reductions in initial acquisition costs, which may be associated with subsequent additional healthcare needs. ConclusionGiven the increasing pressure for reduced costs and efficient allocation of limited healthcare resources, an additional investment in ensuring high medication adherence may lead to greater savings due to a potentially decreased demand for healthcare services. In contrast, savings achieved in acquisition costs may result in a greater net loss due to increased healthcare consumption caused by decreased asthma control.
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spelling pubmed-39029902014-01-29 Potential negative consequences of non-consented switch of inhaled medications and devices in asthma patients Björnsdóttir, U S Gizurarson, S Sabale, U Int J Clin Pract Systematic Review BackgroundAsthma requires individually tailored and careful management to control and prevent symptoms and exacerbations. Selection of the most appropriate treatment is dependent on both the choice of drugs and inhaler device; however, financial pressures may result in patients being switched to alternative medications and devices in an attempt to reduce costs. AimThis review aimed to examine the published literature in order to ascertain whether switching a patient’s asthma medications or device negatively impacts clinical and economic outcomes. Materials and methodsA literature search of MEDLINE (2001–13 September 2011) was conducted to identify English-language articles focused on the direct impact of switching medications and inhaler devices and switching from fixed-dose combination to monocomponent therapy via separate inhalers in patients with asthma; the indirect impacts of switching were also assessed. ResultsEvidence showed that non-consented switching of medications and inhalers in patients with asthma can be associated with a range of negative outcomes, at both individual and organisational levels. Factors that reduce adherence may lead to compromised symptom control resulting in increased healthcare resource utilisation and poorer patient quality of life. DiscussionThe consequences of a non-consented switch should be weighed carefully against arguments supporting an inhaler switch without the patient’s consent for non-medical/budgetary reasons, such as potential reductions in initial acquisition costs, which may be associated with subsequent additional healthcare needs. ConclusionGiven the increasing pressure for reduced costs and efficient allocation of limited healthcare resources, an additional investment in ensuring high medication adherence may lead to greater savings due to a potentially decreased demand for healthcare services. In contrast, savings achieved in acquisition costs may result in a greater net loss due to increased healthcare consumption caused by decreased asthma control. Blackwell Publishing Ltd 2013-09 2013-06-16 /pmc/articles/PMC3902990/ /pubmed/23773278 http://dx.doi.org/10.1111/ijcp.12202 Text en © 2013 The Authors. International Journal of Clinical Practice published by John Wiley & Sons Ltd. Int J Clin Pract, September 2013, 67, 9, 904–910. http://creativecommons.org/licenses/by/3.0/ This is an open access article under the terms of the Creative Commons Attribution–NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
spellingShingle Systematic Review
Björnsdóttir, U S
Gizurarson, S
Sabale, U
Potential negative consequences of non-consented switch of inhaled medications and devices in asthma patients
title Potential negative consequences of non-consented switch of inhaled medications and devices in asthma patients
title_full Potential negative consequences of non-consented switch of inhaled medications and devices in asthma patients
title_fullStr Potential negative consequences of non-consented switch of inhaled medications and devices in asthma patients
title_full_unstemmed Potential negative consequences of non-consented switch of inhaled medications and devices in asthma patients
title_short Potential negative consequences of non-consented switch of inhaled medications and devices in asthma patients
title_sort potential negative consequences of non-consented switch of inhaled medications and devices in asthma patients
topic Systematic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3902990/
https://www.ncbi.nlm.nih.gov/pubmed/23773278
http://dx.doi.org/10.1111/ijcp.12202
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