Poor Compliance to Inhaler Therapy in Bronchial Asthma Patients –A Prospective Study in General Population
Science Journal of Clinical Medicine
Volume 3, Issue 1, January 2014, Pages: 4-9
Received: Nov. 24, 2013;
Published: Dec. 30, 2013
Views 2675 Downloads 221
Gajanan Gaude, Department of Pulmonary Medicine, KLE University’s Jawaharlal Nehru Medical College, Belgaum, Karnataka, INDIA
Jyothi Hattiholi, Department of Pulmonary Medicine, KLE University’s Jawaharlal Nehru Medical College, Belgaum, Karnataka, INDIA
Alisha Chaudhury, Department of Pulmonary Medicine, KLE University’s Jawaharlal Nehru Medical College, Belgaum, Karnataka, INDIA
Background: Considering the prevalence and associated burden of disease due to bronchial asthma, it is mandatory to obtain an optimal control of the disease and to improve outcomes for these patients. Asthma control and treatment compliance are widely investigated issues around the world. But it has been observed that there is very poor adherence to the inhalational therapy which leads to the sub-optimal control of the disease. Objectives of the study: To investigate the adherence for anti-asthma inhalational medications in adults with bronchial asthma. Methodology: A prospective study was done in a total of 400 bronchial asthma patients over a period of 2 years. Once included in the study, the patients were followed up for a total of 12 weeks for calculation of non-adherence to the aerosol therapy. Results: A total of 400 patients of bronchial asthma who were started on inhalational therapy were included in the study. At the end of 12 weeks, it was observed that, only 154 patients (38.5%) had regular compliance and 246 patients (61.5%) were non-compliant to aerosol therapy as prescribed for bronchial asthma. Factors that were associated with poor compliance were: lower educational level status, poor socio-economic status, cumbersome regimens, dislike of medication and distant pharmacies. Non-Drug factors that reduced the compliance were: fears about side effects, anger about condition or its treatment, forgetfulness or complacency and patient’s ill attitudes toward health. Conclusion: Noncompliance in asthma management is a fact of life and no single compliance-improving strategy probably will be as effective as a good physician–patient relationship. Optimal self-management allowing for optimization of asthma control by adjustment of medications may be conducted by either self-adjustment with the aid of a written action plan or by regular medical review.
Poor Compliance to Inhaler Therapy in Bronchial Asthma Patients –A Prospective Study in General Population, Science Journal of Clinical Medicine.
Vol. 3, No. 1,
2014, pp. 4-9.
Cochrane GM. Compliance and outcomes in patients with asthma. Drugs 1996; 52:S12-S19.
Deenen T, Klip EC. Coping with asthma. Respir Med 1993; 87:S67-S70.
Barnes P, Jonsson B, Klim JB. The costs of asthma. Eur Respir J 1996: 9:636-642.
Global Initiative for Asthma (GINA). Global strategy for Asthma Management and Prevention. Bethesda, National Institute of Health, 2011 (Revised 2011). Downloaded from http://www.ginasthma.com (Accessed on December 20, 2012).
Prasad B.G.; Changes proposed in the social classification of Indian family’s. J Indian Med Assoc 1970: 55:198-199.
Pinto Pereira LM, Clement Y, Da Silva CK, McIntosh D, Simeon DT. Understanding and use of inhaler medication by asthmatics in specialty care in Trinidad. Chest 2002; 121: 1833-1840.
Rand CS, Wise RA. Measuring adherence to asthma medication regimens. Am J Respir Crit Care Med 1994; 149:69 –78.
Stern L, Berman J, Lawry W, et al. Medication compliance and disease exacerbation in patients with asthma. Ann Allergy Asthma Immunol 2006; 97:402– 408.
Osterberg L, Blaschke T. Adherence to medication. N Engl J Med 2005; 353:487– 497.
Kaisar HB. Compliance and non-compliance in asthma. Allergy Asthma Proc 2007; 28:514 – 516.
Rhodes L, Moorman JE, Redd SC. Sex differences in asthma prevalence and other diseases in eight states. J Asthma 2005; 42:772-782.
Gibson N A, Ferguson AE, Aitchson TC, Patson JY. Compliance with inhaled asthma medication in preschool children Thorax 1995; 50: 1274-9.
Lewis M, Lewis C. Consequences of empowering children to care for themselves. Pediatrician 1990; 17:63-7
Juniper EF. The impact of patient compliance on effective asthma management. Curr Opin Pulmon Med 2003; 9: S8–S10.
Williams LK, Joseph CL, Peterson EL, et al. Race-ethnicity, crime, and other factors associated with adherence to inhaled corticosteroids. J Allergy Clin Immunol 2007; 119:168 –175.
Lindberg M, Estrom J, Moller M, Ahlner J. Asthma care and factors affecting medication compliance: The patient point of view. Intern J Quality Health Care 2001; 13: 375-383.
Cegala DJ, Marinelli T, Post D. The effects of patient communication skills training on compliance. Arch Fam Med 2000; 9:57-64.
Lin HC, Kao, Wen Hc, Wn CS, Chung CL. Length of stay and costs for asthma patients by hospital characteristics-a five-year population-based analysis. J Asthma 2005; 42: 537–542.
Dowell J, Hudson H. A qualitative study of medication-taking behaviour in primary care. Fam Pract 1997; 14:369–375.
Johnson G, David CMK, Rambha T, Kay S. Factors associated with medication non-adherence in patients with COPD. Chest 2005; 128: 3198 –3204.
Dimatteo MR, Lepper HS, Croghan TW. Depression is a risk factor for noncompliance with medical treatment: Meta analysis of the effects of anxiety and depression on patient adherence. Arch Intern Med 2000; 160: 2101-2107.
Ryan GW, Wagne GJ. Pill taking "routinization": a critical factor to understanding episodic medication adherence. AIDS Care 2003: 15: 795-806.
Gillinssen A. Patient’s adherence in asthma. J Physio Phamacol 2007;58(Suppl 5)205-222.
Kripalani S, Yao X, Haynes B. Interventions to evaluate medications adherence in chronic medical conditions. Arch Intern Med 2007;167:540-550.
Bender BG, and Bender SE. Patient-identified barriers to asthma treatment adherence: Response to interviews, focus groups, and questionnaires. Immunol Allergy Clin North Am 2005; 25:107–130.
Brown MD, Reeves MJ, Meyerson K, et al. Randomized trial of a comprehensive asthma education program after an emergency department visit. Ann Allergy Asthma Immunol 2006; 97:44–51.
Gillissen A, Buschi K, Juergens U. Adherence to therapy in bronchial asthma. Dtsch Med Wochenschr 2007;132(23):1281-1286 (English Abstract).