The value of self-report assessment of adherence, rhinitis and smoking in relation to asthma control

Abstract

Aims: To explore the utility of self-report measures of inhaled corticosteroid (ICS) adherence, degree of rhinitis and smoking status and their association with asthma control.Methods: Patients prescribed ICS for asthma at 85 UK practices were sent validated questionnaire measures of control (Asthma Control Questionnaire; ACQ) and adherence (Medication Adherence Report Scale), a two-item measure of smoking status, and a single-item measure of rhinitis.Results: Complete anonymised questionnaires were available for 3916 participants. Poor asthma control (ACQ >1.5) was associated with reported rhinitis (OR = 4.62; 95% CI: 3.71-5.77), smoking (OR = 4.33; 95% CI: 3.58-5.23) and low adherence to ICS (OR = 1.35; 95% CI: 1.18-1.55). The degree of rhinitis was important, with those reporting severe rhinitis exhibiting the worst asthma control, followed by those reporting mild rhinitis and then those reporting no rhinitis symptoms (F(2, 3913)=128.7, p<.001). There was a relationship between the number of cigarettes smoked each day and asthma control (F(5,655)=6.08, p<.001).Conclusions: Poor asthma control is associated with self-reported rhinitis, smoking and low medication adherence. These potentially modifiable predictors of poor asthma control can be identified through a brief self-report questionnaire, used routinely as part of an asthma review.

Asthma and Adherence to Inhaled Corticosteroids: Current Status and Future Perspectives

“…19 CMA is considered to be reliable way of measuring ICS adherence, as it does not involve patient self-reporting, which leads to overestimated adherence, 52 although clearly communicating a no-blame attitude highly improves the accuracy of self-reporting. 55 One of the major problems with assessing adherence as CMA is that we have no way of knowing if the patients take their medication after filling their prescriptions or if they use the correct inhalation techniques, and thus, actual adherence might be even lower than that calculated.…”

Investigating the organisational factors associated with variation in clinical productivity in community pharmacies: a mixed-methods study

“…The distribution of MARS scores was also highly negatively skewed with a pronounced peak at 25. Consistent with previous research, 59 this score was dichotomised into ≤ 20 ('low adherers') and > 20 ('high adherers'), and analysed using binary logistic regression.…”

“…The SIMS, MARS and BMQ are of proven reliability and validity, and have been widely used in research studies in a number of settings (including pharmacy) across a range of conditions and in several countries. [49][50][51]55,[59][60][61][62] The patient satisfaction scale lists 15 statements that respondents are asked to rate on a five-point Likert scale, from 1 (strongly disagree) to 5 (strongly agree) according to how they felt about their visit to a pharmacy. In addition, following cognitive interview piloting, a 'not applicable' option was provided, which was scored 3 (equivalent to 'neither agree nor disagree').…”

The International Primary Care Respiratory Group (IPCRG) Research Needs Statement 2010

“…85,101 In atopic children, the presence of allergic rhinitis is a risk factor for asthma, with a time interval of about a year before the development of asthma symptoms, 102 offering a potential window of opportunity when early detection and appropriate management of rhinitis may prevent the progression to asthma. Co-morbid rhinitis is associated with increased asthma symptoms, increased exacerbations and hospital admissions, [103][104][105] with some evidence that concomitant treatment can improve control. 106,107 Research questions:…”