Abstract
Promoting adherence to asthma treatment is an essential aspect of clinical practice. Approximately 60% of asthmatic patients are non-adherent to asthma regimen, resulting in adverse outcomes and higher costs of care. Non-adherence could be intentional (perceptions of asthma severity, self-manage therapy, fear of side-effects) or non-intentional (forgetful, cost, and misunderstandings). Adherence can be evaluated by patient’s reporting, dose counter, electronic metered dose inhaler but using pharmacy records is a more cost-effective method. The most successful strategies to improve patients’ adherence is to utilize the principle of patient-centered collaborative care and effective communication. Keys of communication skills consist of establishing a relationship, listening, collaborating on the treatment plan, time management, and implementing effective follow-up interventions. Interventions to improve adherence include providing reinforcement for patients’ efforts to change, providing feedback on progress, tailoring education to patients’ needs and circumstances and follow-up. Evaluation of health literacy is mandatory for prioritizing information from most to least critical, speaking slowly, avoiding medical jargon, and spending minimal extra time during each visit. Communication technology including texting or interactive voice response is another new strategy that can increase adherence.
Highlights
An estimated 300 million people have asthma worldwide
Promoting adherence to asthma treatment is an essential aspect of clinical practice
Keys of communication skills consist of establishing a relationship, listening, collaborating on the treatment plan, time management, and implementing effective follow-up interventions
Summary
An estimated 300 million people have asthma worldwide. The Global Initiative for Asthma (GINA) recommends initial regular controller treatment plus as needed short-acting beta agonist (SABA) for medication therapy. Less than 60% of asthmatic patients have been reported to use medication regularly. This non-adherence burdens both the healthcare costs and undesirable clinical outcomes. The cost of asthma in the industrialized countries such as the USA was reported to be as high as 1% - 2% of total healthcare expenditure [2], not including indirect costs such as lost productivity. The impact of non-adherence on asthma is significant, including frequent asthma exacerbation, increased frequency of emergency visits, and hospitalization. This review article focuses on medication non-adherence and relevant strategies to promote adherence
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