Management of asthma: Adherence, inhaler technique and self-management

Dhruve, Hetal

doi:10.12968/pnur.2018.29.10.465

Cited by 7 publications

(4 citation statements)

References 11 publications

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“…[ 2 ] Different factors affect asthma control, such as a patient’s medication knowledge, adherence and appropriate inhaler techniques. [ 3,4 ] Poor medication knowledge leads to wrong beliefs that further affect patients' adherence to medication. [ 5 ] Poor adherence is linked to poor disease outcomes such as increased mortality, increased cost and increased rate of hospital admission.…”

Section: Introductionmentioning

confidence: 99%

Assessment of medication knowledge among patients with asthma

Almomani

Altawalbeh

Alnajjar

et al. 2020

Journal of Pharmaceutical Health Services Research

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Objectives Asthmatic patient's knowledge about their treatment can affect asthma control and adherence level. This study investigated the level of medication knowledge, the level of adherence and factors affecting both knowledge and adherence in adult patients with asthma. Methods A cross‐sectional study was carried out in Jordan between 2017 and 2018. A face‐to‐face interview was conducted by a clinical pharmacist with asthma patients attending hospital pharmacies for refilling their prescriptions. Key findings A total of 218 adults with asthma were included into the study and 60.6% were knowledgeable about their medications. University degree education (OR = 3.67; P value < 0.001), positive family history of asthma (OR = 1.89; P value = 0.04) and longer asthma duration (OR = 1.03; P value = 0.049) were significantly associated with a high medication knowledge. On the other hand, married participants were less knowledgeable than single ones (OR = 0.30; P value = 0.041). High medication knowledge score (OR = 4.76, P value = 0.008), older age (OR = 1.06, P value = 0.004) and male gender (OR = 3.82, P value = 0.01) were significant predictors of high medication adherence. Conclusions These findings highlight the importance of educational programmes that should be conducted in primary healthcare settings, such as community pharmacies, where pharmacists should educate patients about their medication and the importance of adherence.

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Section: Introductionmentioning

confidence: 99%

Assessment of medication knowledge among patients with asthma

Almomani

Altawalbeh

Alnajjar

et al. 2020

Journal of Pharmaceutical Health Services Research

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“… 31 One study indicated that detecting patients’ non-adherence behaviours and appreciating their self-management may help to change their behaviour and increase adherence. 35 On the other hand, patients think that their physicians did not have enough time or provide enough information to them, which contributed to patients lack of sufficient knowledge of the importance of treatment adherence to controlling their asthma. 22 , 29 A systematic review reported that patient–provider interactions was significantly related to treatment adherence and patient health outcomes; 36 so it is likely that adherence would increase if the rationale of the treatment plan was explained in a way that patients can understand and follow.…”

Section: Discussion and Recommendationsmentioning

confidence: 99%

Medication Adherence in People with Asthma: A Qualitative Systematic Review of Patient and Health Professional Perspectives

Zhang¹,

Ding²,

Zhang³

et al. 2023

JAA

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Background Increased medication adherence leads to better asthma control and health outcomes. However, many studies have found that patient adherence to maintenance medication is poor. Aim We undertook a meta-synthesis of qualitative studies, to investigate asthma patient and healthcare professionals’ perspectives of medication adherence. Methods This systematic review was reported by following the PRISMA guidelines. The Joanna Briggs Institute (JBI) meta-aggregative approach was used for the qualitative synthesis. The protocol was registered in PROSPERO (CRD42022346831). Results In total, 12 articles were included in the review. These articles reported findings from 433 participants in total, which included 315 patients and 118 healthcare professionals. Four synthesised findings with sub-themes were identified from the reviewed studies. These synthesised findings were described as: 1) The role of relationship and communication with/between Healthcare Professionals in medication adherence; 2) Insufficient information from Healthcare Professionals acting as a barrier for adherence; 3) How patient’s attitude/beliefs effect their adherence to medication; and 4) Patients’ personal behaviour and other relevant barriers. Conclusion The synthesized findings provide a strong evidence-base of patient and health professionals’ perspectives and behaviours toward medication adherence, which helps to identify and address non-adherence. Healthcare providers can use these findings to support patients’ adherence to asthma medications. The findings suggest that empowering people to make informed decisions around medication adherence rather than “adherence controlling” by health professionals is very important. Effective dialogue and appropriate education are critical approaches to increase medication adherence.

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“…Patients reported that the lack of self-efficacy to recognise their asthma symptoms and also to distinguish these accurately from other symptoms, such as breathlessness caused by physical exertion, prevented them from the appropriate use of medication and from avoiding triggers [92]. Depending on the patient's level of knowledge, self-efficacy to self-manage and their illness perception, a stratified combination of asthma education with checking correct inhaler technique, good HCP-patient relationship and interventions to increase patients' motivation to self-manage, can be beneficial to improve treatment adherence [92,93]. Indeed, written or oral asthma action plans, that is detailed plans for self-management including actions when asthma worsens, also showed some benefits, but further research is needed to fully understand their most effective components, their implementation barriers and facilitators both from patients' and healthcare professionals' points of view [94,95].…”

Section: Educational Approachesmentioning

confidence: 99%

Multimorbidity in Difficult Asthma: The Need for Personalised and Non-Pharmacological Approaches to Address a Difficult Breathing Syndrome

Varkonyi-Sepp

Freeman

Ainsworth

et al. 2022

JPM

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Three to ten percent of people living with asthma have difficult-to-treat asthma that remains poorly controlled despite maximum levels of guideline-based pharmacotherapy. This may result from a combination of multiple adverse health issues including aggravating comorbidities, inadequate treatment, suboptimal inhaler technique and/or poor adherence that may individually or collectively contribute to poor asthma control. Many of these are potentially “treatable traits” that can be pulmonary, extrapulmonary, behavioural or environmental factors. Whilst evidence-based guidelines lead clinicians in pharmacological treatment of pulmonary and many extrapulmonary traits, multiple comorbidities increase the burden of polypharmacy for the patient with asthma. Many of the treatable traits can be addressed with non-pharmacological approaches. In the current healthcare model, these are delivered by separate and often disjointed specialist services. This leaves the patients feeling lost in a fragmented healthcare system where clinical outcomes remain suboptimal even with the best current practice applied in each discipline. Our review aims to address this challenge calling for a paradigm change to conceptualise difficult-to-treat asthma as a multimorbid condition of a "Difficult Breathing Syndrome" that consequently needs a holistic personalised care attitude by combining pharmacotherapy with the non-pharmacological approaches. Therefore, we propose a roadmap for an evidence-based multi-disciplinary stepped care model to deliver this.

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Management of asthma: Adherence, inhaler technique and self-management

Cited by 7 publications

References 11 publications

Assessment of medication knowledge among patients with asthma

Assessment of medication knowledge among patients with asthma

Medication Adherence in People with Asthma: A Qualitative Systematic Review of Patient and Health Professional Perspectives

Multimorbidity in Difficult Asthma: The Need for Personalised and Non-Pharmacological Approaches to Address a Difficult Breathing Syndrome

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