Abstract
One of the main challenges in asthma control is adherence to pharmaceutical treatment. The aim of this study was to test the association between adherence to asthma medication, control and medical beliefs, cognitive and emotional perceptions using three different validated questionnaires. Beliefs about asthma medicine, cognitive and emotional factors were determined in a cross-sectional survey of patients attending outpatient pulmonologist practices in Latvia (n = 352). The validated Beliefs about Medicines Questionnaire and the Brief Illness Perception Questionnaire were used. Adherence to asthma medication was assessed using the Morisky Medication Adherence Scale and two different versions of the Medication Adherence Reporting Scale. Several questions about necessity or concerns related to pharmaceutical treatment were able to predict poor adherence according to the Morisky scale. If the patient felt that without the asthma medication his life would be impossible, his risk to have poor treatment adherence was 46% reduced (odds ratio 0.54; 95% confidence interval 0.33–0.89). Furthermore, asthma patients who were convinced that their health depends on the asthma treatment were less likely to have poor treatment adherence (odds ratio 0.56: 95% confidence interval 0.32–0.97). In case the patient was concerned by the need to constantly use asthma medication or sometimes concerned by long-term effects of asthma medication the odds of poor treatment adherence were 1.96 (95% confidence interval 1.19–3.24) and 2.43 (95% confidence interval 1.45–4.08), respectively. In conclusion, medication beliefs, particularly concerns and necessity of asthma treatment were associated with poor treatment adherence when assessed with the Morisky or 5-item Medication Adherence Reporting Scale.
Highlights
Asthma is a serious global health problem affecting approximately 300 million people worldwide.[1, 2] The estimated prevalence of people living with asthma ranges from 1 to 21% in adults and with up to 20% of children aged 6–7 years experiencing severe wheezing episodes within a year.[3, 4]One of the main challenges in asthma control is adherence to pharmaceutical treatment
Asthma patients who were convinced that their health depends on the asthma treatment were less likely to have poor treatment adherence
In case the patient was concerned by the need to constantly use asthma medication or sometimes concerned by long-term effects of their asthma medication the odds of poor treatment adherence were 1.96 and 2.43, respectively
Summary
One of the main challenges in asthma control is adherence to pharmaceutical treatment. Poor adherence is common across many chronic diseases such as asthma.[5, 6] As it is not easy to test clinically for adherence, several questionnaires have been developed to assess adherence to medication.[7, 8] These questionnaires are widely used in many countries. No information is available on treatment adherence of asthma patients in Latvia. Some of these factors are related to complexity of the therapy, fear of side effects of drugs, method of taking the drug, dosage regimen, adverse events, knowledge about the essence of the disease and its complications, illness perception and social support.[6, 9, 10]
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