Skip to main content
padlock icon - secure page this page is secure

Identifying patient‐specific beliefs and behaviours for conversations about adherence in asthma

Buy Article:

$52.00 + tax (Refund Policy)

Abstract

Background:  Asthma guidelines advise addressing adherence at every visit, but no simple tools exist to assist clinicians in identifying key adherence‐related beliefs or behaviours for individual patients.

Aims:  To identify potentially modifiable beliefs and behaviours that predict electronically recorded adherence with controller therapy.

Methods:  Patients aged ≥14 years with doctor‐diagnosed asthma who were prescribed inhaled corticosteroid/long‐acting β2‐agonist (ICS/LABA) completed questionnaires on medication beliefs/behaviours, side‐effects, Morisky adherence behaviour score and Asthma Control Test (ACT), and recorded spirometry. Adherence with ICS/LABA was measured electronically over 8 weeks. Predictors of adherence were identified by univariate and multivariate analyses.

Results:  99/100 patients completed the study (57 female; forced expiratory volume in 1 s mean ± standard deviation 83 ± 23% predicted; ACT 19.9 ± 3.8). Mean electronically recorded adherence (n= 85) was 75% ± 25, and mean self‐reported adherence was 85% ± 26%. Factor analysis of questionnaire items significantly associated with poor adherence identified seven themes: perceived necessity, safety concerns, acceptance of asthma chronicity/medication effectiveness, advice from friends/family, motivation/routine, ease of use and satisfaction with asthma management. Morisky score was moderately associated with actual adherence (r=−0.45, P < 0.0001). In regression analysis, 10 items independently predicted adherence (adjusted R 2= 0.67; P < 0.001). Opinions of friends/family about the patient's medication use were strongly associated with poor adherence. Global concerns about ICS/LABA therapy were more predictive of poor adherence than were specific side‐effects; the one‐third of patients who reported experiencing side‐effects from their steroid inhaler had lower adherence than others (mean 62% vs 81%; P= 0.015).

Conclusions:  This study identified several specific beliefs and behaviours which clinicians could use for initiating patient‐centred conversations about medication adherence in asthma.
No References
No Citations
No Supplementary Data
No Article Media
No Metrics

Document Type: Research Article

Affiliations: 1: Woolcock Institute of Medical Research, University of Sydney 2: Faculty of Pharmacy 3: Department of General Practice, Sydney Medical School – Western, University of Sydney, Sydney, New South Wales 4: Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, Maryland, USA

Publication date: June 1, 2012

  • Access Key
  • Free content
  • Partial Free content
  • New content
  • Open access content
  • Partial Open access content
  • Subscribed content
  • Partial Subscribed content
  • Free trial content
Cookie Policy
X
Cookie Policy
Ingenta Connect website makes use of cookies so as to keep track of data that you have filled in. I am Happy with this Find out more