The Relationship Between Self-reported Non-adherence (NA) To Anti-inflammatory Therapy and Asthma Management Behaviors/Attitudes Related to NA in Adult Patients

Abstract

RATIONALE: Identifying patient adherence status and reasons for NA are important components of EPR3 and GINA 2008 Guidelines. METHODS: 518 adults (79.5% female; 68.9% Caucasian; mean age 41 yrs.) with intermittent and persistent asthma completed the AsthmaPACT, an asthma survey hosted by the Asthma and Allergy Foundation of America website. RESULTS: 350 (67.6%) of the sample reported taking one or more anti-inflammatory medication. Of these, 106 (32.5%) were diagnosed as NA, by reporting taking at least one anti-inflammatory “less than prescribed by their physician”. Links between self-reported NA and items intended to assess risk factors to NA were examined using chi square statistics. Individuals who reported taking anti-inflammatory medication less than prescribed were more likely to report: 1) Ineffective asthma management behaviors: not follow the asthma medication plan p<0.001; often delay treatment for asthma symptoms p<.001; not follow instructions to treat an asthma attack p<,001; not remove self from area that may be causing symptoms p=.039; not measure peak flow when having symptoms p<001; 2) Negative attitudes about treatment: do not need medication p=.012; medication does not work p=.035; disagrees with the treatment plan p=.007 CONCLUSIONS: The AsthmaPACT provides an assessment of 1) risk-factors for non-adherence and 2) patient self-report of adherence. Findings in this study are consistent with GINA 2008 Guidelines in that common barriers to adherence and specifically behaviors and attitudes about medication use are related to NA. The AsthmaPACT might be considered for symptomatic patients to identify barriers to treatment and adherence status.