The relationship between exhaled nitric oxide and compliance/adherence in patients with bronchial asthma using inhaled corticosteroids

Background: The measurement of FENO is the important index to evaluate the control of the patients with bronchial asthma using inhaled corticosteroids (ICS). When FENO in the patients using ICS is high, we often try to increase the dose of ICS. However, it is necessary to take compliance/adherence of the patients into consideration before that. Objectives: The aim of this study was to examine whether the measurement of FENO is useful as the index of compliance/adherence to asthma treatment by ICS. Methods: One hundred forty-seven subjects (4 to 23 years of age; 82 male, 65 female) with bronchial asthma using ICS were recruited from the outpatient division at the Department of Pediatrics at Fukuoka National Hospital between January-August in 2011. We measured their FENO and asked them to complete a questionnaire regarding the use of ICS. We asked them how often they inhaled ICS for a month, and classified them into five groups categorized as the grade of compliance. Additionally, we made a questionnaire about adherence. The patients answered that they inhaled ICS by themselves were defined as good adherence group, and otherwise as poor adherence group. We compared FENO in 5 groups categorized as the grade of compliance. Likewise, we also compared FENO in good and poor adherence groups. Results: FENO in the patients of good compliance groups were significantly lower than that of poor compliance groups (p Conclusions: It was indicated that the measurement of FENO could be useful as the index of compliance to asthma treatment by ICS.