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:

* patient has been diagnosed with asthma for at least 6 months
* patient can be managed appropriately on study medications as determined by the attending physician

Exclusion Criteria:

* patient shows evidence of neurological or significant cognitive impairment
B: Inclusion Criteria (patient-level):

* Age 5-56 years
* Physician diagnosis of asthma
* Continuous HMO enrollment with prescription drug rider
* Electronic prescription of an inhaled corticosteroid

Exclusion Criteria (patient-level):

* Diagnosis of chronic obstructive pulmonary disease
* Diagnosis of congestive heart failure

Inclusion Criteria (practice-level):

* Primary care practice (i.e., pediatrics, family practice, or internal medicine) within the health system. A practice is defined as a group of physicians who by virtue of speciality or geography care for a relatively contained population of patients and who cross-cover the care of these patients.

Exclusion Criteria (practice-level):

* None
C: 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
D: Inclusion Criteria:

* Received treatment for asthma in the year prior to study entry
* Received at least one respiratory medication at a Kaiser Permanente Northwest (KPNW) or Kaiser Permanente Hawaii (KPH) outpatient pharmacy in the year prior to study entry
* Continuous Kaiser Permanente membership from the year prior to study entry through study entry
* Willing to participate in the study

Exclusion Criteria:

* Excluded from primary analyses if fewer than three months of follow-up

Answer: C