@article { , title = {Medication adherence in patients with severe asthma prescribed oral corticosteroids in the U-BIOPRED cohort}, abstract = {Background: Although estimates of suboptimal adherence to oral corticosteroids in asthma range from 30\% to 50\%, no ideal method for measurement exists; the impact of poor adherence in severe asthma is likely to be particularly high. Research Questions: What is the prevalence of suboptimal adherence detected by self-reporting and direct measures? Is suboptimal adherence associated with disease activity? Study Design and Methods: Data were included from individuals with severe asthma taking part in the U-BIOPRED (Unbiased Biomarkers for the Prediction of Respiratory Disease Outcomes) study and prescribed daily oral corticosteroids. Participants completed the Medication Adherence Report Scale, a five-item questionnaire used to grade adherence on a scale from 1 to 5, and provided a urine sample for analysis of prednisolone and metabolites by liquid chromatography-mass spectrometry. Results: Data from 166 participants were included in this study: mean (SD) age, 54.2 (± 11.9) years; FEV1, 65.1\% (± 20.5\%) predicted; female, 58\%; 37\% completing the Medication Adherence Report Scale reported suboptimal adherence; and 43\% with urinary corticosteroid data did not have detectable prednisolone or metabolites in their urine. Good adherence by both methods was detected in 49 of the 142 (35\%) of participants in whom both methods were performed; adherence detection did not match between methods in 53\%. Self-reported high adherers had better asthma control and quality of life, whereas directly measured high adherers had lower blood eosinophil levels. Interpretation: Low adherence is a common problem in severe asthma, whether measured directly or self-reported. We report poor agreement between the two methods, suggesting some disassociation between self-assessment of medication adherence and regular oral corticosteroid use, which suggests that each approach may provide complementary information in clinical practice.}, doi = {10.1016/j.chest.2021.02.023}, eissn = {1931-3543}, issn = {0012-3692}, issue = {1}, journal = {Chest}, pages = {53-64}, publicationstatus = {Published}, publisher = {Elsevier}, url = {https://hull-repository.worktribe.com/output/3709738}, volume = {160}, keyword = {Health and Health Inequalities, Asthma, Adherence, Urinary corticosteroids}, year = {2021}, author = {Ahmed, H. and Auffray, C. and Bakke, P. and Bush, A. and Baribaud, F. and Bates, Stewart and Bel, E. H. and Bigler, J. and Bisgaard, H. and Boedigheimer, M. J. and Bønnelykke, K. and Brandsma, J. and Brinkman, P. and Bucchioni, E. and Burg, D. and Caruso, M. and Chaiboonchoe, A. and Chanez, P. and Chung, F. K. and Compton, C. H. and Corfield, J. and D'Amico, A. and Dahlèn, B. and De Meulder, B. and Djukanovic, R. and Erpenbeck, V. J. and Erzen, D. and Fichtner, K. and Fitch, N. and Fleming, L. J. and Formaggio, E. and Fowler, S. J. and Frey, U. and Gahlemann, M. and Geiser, T. and Goss, V. and Guo, Y. and Hashimoto, S. and Haughney, J. and Hedlin, G. and Hekking, P. W. and Higenbottam, T. and Hohlfeld, J. M. and Holweg, C. and Horváth, I. and Howarth, P. and James, A. J. and Knowles, R. G. and Knox, A. J. and Krug, N. and Lefaudeux, D. and Loza, M. J. and Lutter, R. and Manta, A. and Masefield, S. and Matthews, J. G. and Mazein, A. and Meiser, A. and Middelveld, R. J.M. and Miralpeix, M. and Montuschi, P. and Mores, N. and Murray, C. S. and Musial, J. and Myles, D. and Singer, Florian and Wagers, Scott and Chung, Kian Fan and Dahlen, Sven Erik and Dahlén, Barbro and Horvath, Ildiko and Sun, Kai and Pandis, Ioannis and Alahmadi, Fahad H and Simpson, Andrew J. and Gomez, Cristina and Ericsson, Magnus and Thörngren, John Olof and Wheelock, Craig and Shaw, Dominic E and Fleming, Louise J and Roberts, Graham and Riley, John and Bates, Stewart and Sousa, Ana R and Knowles, Richard and Bansal, Aruna T and Corfield, Julie and Pandis, Ioannis and Sun, Kai and Bakke, Per S and Caruso, Massimo and Chanez, Pascal and Dahlén, Barbro and Horvath, Ildiko and Krug, Norbert and Montuschi, Paolo and Singer, Florian and Wagers, Scott and Adcock, Ian M and Djukanovic, Ratko and Chung, Kian Fan and Sterk, Peter J and Dahlen, Sven Erik and Fowler, Stephen J and Study Group, U-BOPRED} }