Factors related to good asthma control using different medical adherence scales in Latvian asthma patients: an observational study

Abstract

One of the main challenges in asthma control is adherence to pharmaceutical treatment. The aim of this study was to test the association between adherence to asthma medication, control and medical beliefs, cognitive and emotional perceptions using three different validated questionnaires. Beliefs about asthma medicine, cognitive and emotional factors were determined in a cross-sectional survey of patients attending outpatient pulmonologist practices in Latvia (n = 352). The validated Beliefs about Medicines Questionnaire and the Brief Illness Perception Questionnaire were used. Adherence to asthma medication was assessed using the Morisky Medication Adherence Scale and two different versions of the Medication Adherence Reporting Scale. Several questions about necessity or concerns related to pharmaceutical treatment were able to predict poor adherence according to the Morisky scale. If the patient felt that without the asthma medication his life would be impossible, his risk to have poor treatment adherence was 46% reduced (odds ratio 0.54; 95% confidence interval 0.33–0.89). Furthermore, asthma patients who were convinced that their health depends on the asthma treatment were less likely to have poor treatment adherence (odds ratio 0.56: 95% confidence interval 0.32–0.97). In case the patient was concerned by the need to constantly use asthma medication or sometimes concerned by long-term effects of asthma medication the odds of poor treatment adherence were 1.96 (95% confidence interval 1.19–3.24) and 2.43 (95% confidence interval 1.45–4.08), respectively. In conclusion, medication beliefs, particularly concerns and necessity of asthma treatment were associated with poor treatment adherence when assessed with the Morisky or 5-item Medication Adherence Reporting Scale.

Treatment adherence in Asthma and Attention Deficit Hyperactivity Disorder (ADHD), Personality traits, Beliefs about medication and Illness perception

“…This finding is in line with the conclusion of a meta-analysis including 26 studies on adherence to medication prescribed to treat numerous diseases (Brandes & Mullan, 2014), in which a weak relation between illness perception and adherence behaviour emerged, while a recent study on persons with asthma found however no associations (Smits, Brigis, Pavare, Maurina, & Barengo, 2017). Note that the illness perception assessments in these studies, as in the present one, were based on scales derived from the Common-Sense Model (CSM), in which perceptions of illness are theorized to explain health behaviour (Cameron & Leventhal, 2003;Leventhal et al, 2003).…”

“…Note that the illness perception assessments in these studies, as in the present one, were based on scales derived from the Common-Sense Model (CSM), in which perceptions of illness are theorized to explain health behaviour (Cameron & Leventhal, 2003;Leventhal et al, 2003). Hence, the conclusion is that CSM are only weakly linked with adherence to medication, and therefore the CSM framework is only poorly supported by our and others' results (Brandes & Mullan, 2014;Smits et al, 2017). In addition, the B-IPQ seems to be of limited value in adherence assessments in adolescents with ADHD.…”

Treatment perceptions in patients with asthma: Synthesis of factors influencing adherence

“…16 (44%) of the studies reported on patients using preventer asthma medications [33,39,41,44,[50][51][52][54][55][56]62,66,68,[70][71][72], seven (19%) on a combination of preventer and reliever therapies [13,42,45,47,48,67,69]; eight (22%) on different treatments for different groups within the studies (monotherapy and combination therapies) [49,53,[57][58][59]61,63,64]. In five (14%) of the studies, no type of medication was stated [40,43,46,60,65].…”

“…Twenty-four of the studies (67%) [13,39,41,42,[44][45][46][48][49][50][52][53][54]56,57,60,61,65,[67][68][69][70][71][72] used specifically designed study-specific questions to explore patients' perceptions of treatment including beliefs, behaviours and attitudes toward medications. The validated Beliefs about Medicines Questionnaire (BMQ), which measures patient treatment beliefs, was used in 12 (33%) studies [33,40,43,47,51,55,58,59,[62][63][64]66], whilst five (14%) used the validated Illness Perceptions Questionnaire [33,43,58,59,66] which elicits patient beliefs about their illness.…”

“…The included studies covered 18 different countries: 11 studies took place in the USA [39,44,54,56,59,63,66,68,[70][71][72], five in the UK [13,33,42,43,67], four in The Netherlands [41,51,55,62], three in Sweden [40,47,64], three in Australia [48,49,73] and one each in Nigeria [46], Saudi Arabia [50], Taiwan [52], France [53], Latvia [58], Iran [60], Denmark [61]. Chiu et al [45] did not specify in which six Asian countries they conducted their study and two studies [65,69] did not state the country.…”