Time and Risk Preferences and the Use of Asthma Controller Medication

Abstract

The risk tolerance and time preferences of the target group should be considered when designing an asthma-intervention program. Individuals who strongly prefer immediate gratification over future benefits and are willing to tolerate uncertain outcomes are unlikely to adhere to controller medication, regardless of their asthma attitudes. In contrast, efforts to affect relevant attitudes will be most fruitful for individuals with low rates of risk tolerance and time preference. However, as we cannot extrapolate these results to a larger population, we must view them with caution.

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

“…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.…”

“…26 (72%) of the included studies had adult participants (≥20 years old) [33,[39][40][41][42][44][45][46][47]49,50,52,[54][55][56][57][58][59][61][62][63][64]66,[68][69][70] and 6 (17%) adolescents (between 12 and 20 years) [13,51,65,67,71,72]. The age threshold for adult and adolescent participants within this review was guided by the age categories used in a study by Wamboldt et al [72] who categorised patients between 12 and 20 years old as adolescents.…”

“…Studies used either validated questionnaires or designed study-specific questions, with some studies using more than one questionnaire. 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 most common concerns reported regarding medication adherence were: immediate and long-term side effects (58%) [13,33,39,42,44,45,[48][49][50][51][52]55,56,58,59,61,[68][69][70][71], worries about safety (19%) [39,45,46,[48][49][50]54] and the belief that people can become addicted to, or dependent on, asthma medication (31%) [39,42,[48][49][50]56,61,65,68,70,71]. One study reported that general concerns regarding ICS/LABA therapy were more predictive of patients' poor adherence than specific side effects [48].…”

“…Another theme related to asthma attracting unwanted attention in the form of social stigma related to having an illness, with 8 (22%) of the studies reporting on embarrassment as a reason contributing to poor adherence [13,42,45,65,67,69,71,72]. In one study, the social comparisons with their healthy peers around the illness led to feelings of embarrassment about their asthma and described how a parent promoted the belief that 'real men' don't take medications, unless one is 'sick' [72].…”