Nonadherence with asthma medication in teenagers

Abstract

Background: Non-adherence with asthma therapies contributes to increased rates of hospitalisations and asthma deaths. Data from a schools-based questionnaire found that 29% of students do not take their reliever inhaler, and 56.4% do not take their preventer; 23.2% said this was deliberate. Aims: The primary aim was to assess reasons for non-adherence with asthma medications among secondary school students. The secondary aim was to explore solutions to nonadherence. Methods: 58 students were recruited from four secondary schools in London to participate in a focus group. All students were 11 to 18 years old with asthma. The discussion was informed by the outcomes of a school-based questionnaire assessing asthma control and medication adherence. Comments were analysed to identify potential reasons for, and solutions to, non-adherence with asthma medications in teenagers. Results: Three main themes emerged regarding nonadherence: forgetting (25.3%), social issues (22.8%) e.g. “they don’t want to tell people they have asthma”, and inhaler efficacy (11.4%) e.g. “they might think it will be wasting their time to take their inhaler”. Other comments included undesirable side-effects and medication concerns, e.g. “I don’t want to rely on an inhaler for running”. 78.6% of students did not know enough about asthma, and 93.1% thought knowledge would lead to better adherence. 35.5% of students wanted to learn more about medications, including how inhalers work and how to use them correctly. Conclusions: The findings suggest that improved knowledge, and overcoming social barriers, could improve adherence in teenagers. These findings will inform the development of a school-based self-management intervention, aimed at improving adherence and asthma control.