Use Of Asthma Control Indicators In Measuring Efficacy Of Inhaled Corticosteroids In Asthmatic Smokers: A Systematic Review

Abstract

RationaleAcross studies investigators have reached competing conclusions regarding the effectiveness of inhaled corticosteroids (ICS) on improving asthma control in smokers. We completed a systematic review of literature on the use of asthma control indicators to 1. Determine how current research measures efficacy of ICS in asthmatic smokers as well as to 2. Determine if current research supports claims that asthmatic smokers are resistant to the effects of ICS.MethodsOn-line databases PubMed, CINAHL, and PsycINFO were searched using terms relating to asthma, tobacco use, and corticosteroid effectiveness. Eligibility criteria included: Articles published between 2005 and 2013, English language, human subjects, adults (19 and older), and studies using at least one indicator of control as a measure of ICS effectiveness. The prevalence of asthma control indicators as well as outcomes of individual studies were compiled and analyzed to determine efficacy of ICS in patients.ResultsTwelve studies met search criteria. Seven of these used only 1 indicator to measure asthma control in smokers. Additionally, ICS was found to be effective for smokers in only 4 of these studies. ICS was found to be effective in all studies which used at least 5 indicators to measure control.ConclusionsInhaled corticosteroids are shown to improve asthma in smokers when multiple control indicators are used to measure effectiveness. Future studies should 1. Evaluate the effectiveness of ICS using multiple indicators of control, as well as 2. Monitor patient adherence to ICS in studies when determining appropriate asthma therapies for smokers. RationaleAcross studies investigators have reached competing conclusions regarding the effectiveness of inhaled corticosteroids (ICS) on improving asthma control in smokers. We completed a systematic review of literature on the use of asthma control indicators to 1. Determine how current research measures efficacy of ICS in asthmatic smokers as well as to 2. Determine if current research supports claims that asthmatic smokers are resistant to the effects of ICS. Across studies investigators have reached competing conclusions regarding the effectiveness of inhaled corticosteroids (ICS) on improving asthma control in smokers. We completed a systematic review of literature on the use of asthma control indicators to 1. Determine how current research measures efficacy of ICS in asthmatic smokers as well as to 2. Determine if current research supports claims that asthmatic smokers are resistant to the effects of ICS. MethodsOn-line databases PubMed, CINAHL, and PsycINFO were searched using terms relating to asthma, tobacco use, and corticosteroid effectiveness. Eligibility criteria included: Articles published between 2005 and 2013, English language, human subjects, adults (19 and older), and studies using at least one indicator of control as a measure of ICS effectiveness. The prevalence of asthma control indicators as well as outcomes of individual studies were compiled and analyzed to determine efficacy of ICS in patients. On-line databases PubMed, CINAHL, and PsycINFO were searched using terms relating to asthma, tobacco use, and corticosteroid effectiveness. Eligibility criteria included: Articles published between 2005 and 2013, English language, human subjects, adults (19 and older), and studies using at least one indicator of control as a measure of ICS effectiveness. The prevalence of asthma control indicators as well as outcomes of individual studies were compiled and analyzed to determine efficacy of ICS in patients. ResultsTwelve studies met search criteria. Seven of these used only 1 indicator to measure asthma control in smokers. Additionally, ICS was found to be effective for smokers in only 4 of these studies. ICS was found to be effective in all studies which used at least 5 indicators to measure control. Twelve studies met search criteria. Seven of these used only 1 indicator to measure asthma control in smokers. Additionally, ICS was found to be effective for smokers in only 4 of these studies. ICS was found to be effective in all studies which used at least 5 indicators to measure control. ConclusionsInhaled corticosteroids are shown to improve asthma in smokers when multiple control indicators are used to measure effectiveness. Future studies should 1. Evaluate the effectiveness of ICS using multiple indicators of control, as well as 2. Monitor patient adherence to ICS in studies when determining appropriate asthma therapies for smokers. Inhaled corticosteroids are shown to improve asthma in smokers when multiple control indicators are used to measure effectiveness. Future studies should 1. Evaluate the effectiveness of ICS using multiple indicators of control, as well as 2. Monitor patient adherence to ICS in studies when determining appropriate asthma therapies for smokers.