Understanding Asthma Medical Nonadherence In Adult and Pediatric Populations

Abstract

Medical nonadherence has been identified as a significant reason for poor asthma control. The Medical Adherence Report Scale for Asthma (MARS-A) questionnaire, a 10 item self-reported measure of adherence with inhaled corticosteroids, provides insights to nonadherence behavior. We hypothesized that medical nonadherence among both adult and children are more likely due to unintentional nonadherence than intentional nonadherence. 115 adult patients between the ages of 46-77 and 159 pediatric patients between the ages of 4-11completed the study. 283 MARS-A surveys from the adult group and 254 from the pediatric group were collected during multiple visits from June 2010 to May 2011. Cronbach’s alpha was calculated to assess the internal validity of the data. Nonparametric one-way ANOVA was used to globally compare the mean responses to each question. Unintentional medical nonadherence was defined by question 1 and intentional medical nonadherence was defined by Questions 2-9. A pairwise comparison using the Bonferroni approach was used to determine any differences between the questions. Cronbach's alpha was 0.84 for the adult group and 0.80 for the pediatric group. ANOVA showed a very large significant difference (p<106) between the mean values of the 10 questions for both groups. Bonferroni approach showed question 1 was statistically lower than other questions except question 9 in the adult and question 10 in the pediatric populations. This study supports the importance of addressing unintentional medication nonadherence to improve overall asthma medication adherence for both adult and pediatric patients.