Please select the eligibility criteria that correspond to the clinical trial below.
Title: Prospective Study of the Feedback From an Adherence Monitor on Asthma Control
Brief Summary: Inhaled medications are the mainstay of the therapeutic management of respiratory disorders. Considered by many to be 'simple' and 'easy' to use, clinicians are aware that inhalers are often improperly used. However, there is no tool that can detect and record errors in either the timing or the method dose administration

The investigators designed a device that makes an acoustic record each time an inhaler is used. Opening the device makes an acoustic file which is recorded, this file is "time-stamped" which means that the timing of drug administration is recorded. When the device is retrieved and acoustic analysis performed, the steps involved in using the inhaler can be determined. Hence, the subjects inhaler technique is assessed and errors in the inhaler use identified. Together this means that errors in inhaler technique and timing of use can be quantified.

In this study the investigators attached the device to a discus dry powder inhaler. In order to eliminate the behavioral component of adherence and identify the mechanical issues associated with effective inhaler use the investigators studied subjects who were already in Hospital and already prescribed a discus inhaler. The investigators hypothesized that the device would identify which errors in technique were the most common and that this would provide insight into how these errors might be eliminated.


Options:
A: Inclusion Criteria:

Children will be eligible if they:

* are ages 8 through 16 years,
* are able to speak English or Spanish,
* can read the assent form,
* are present at the visit with an adult caregiver (parent or legal guardian) who can speak English or Spanish and who is at least 18 years of age,
* have mild, moderate, or severe persistent asthma, and
* are present for an asthma-related visit (either acute or scheduled).
B: Inclusion Criteria:

* Patients prescribed therapy equivalent to step 3 or higher on the Asthma Management Guidelines for at least 3 months
* At least one exacerbation in the previous year with systemic glucocorticoids
* Uncontrolled/Partially Controlled Asthma by GINA guidelines

Exclusion Criteria:

* Allergy to salmeterol/fluticasone
* Patients Controlled by GINA guidelines
C: Inclusion Criteria:

1. Physician diagnosed mild to moderate asthma according to CTS criteria
2. Asthmatics from Chinese and Punjabi communities in the Greater Vancouver Area (GVA), BC
3. Age greater than 21 years
4. Immigrated to Canada in the last 10 yrs
5. Patients who are able to give informed consent and are willing to participate in the study

Exclusion Criteria:

1. Age less than 21 years
2. Other immigrants than Punjabi and Chinese
3. Immigrated before 1998
4. Patients who do not want to sign the consent form
D: Inclusion Criteria:

* 18 years and older
* Admitting diagnosis of asthma or COPD
* Physician- diagnosed asthma, asthma/COPD, or COPD. We will enroll patients even if the primary reason for admission is not asthma or COPD (e.g., patients admitted for heart failure, but with a physician diagnosis of COPD are eligible)
* Patient will be discharged home on a Metered Dose Inhaler (MDI; e.g., albuterol)

Exclusion Criteria:

* Currently in an intensive care unit
* Physician declines to provide consent
* Patient unable to provide consent (e.g., history of cognitive impairment, unable to understand English) or declines to provide consent
* Previous participant in this study

Answer: B