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

Lycett, Helen; Wildman, Emilie; Raebel, Eva M.; Sherlock, Jon-Paul; Kenny, Tom; Chan, Amy Hai Yan

doi:10.1016/j.rmed.2018.06.032

Cited by 51 publications

(38 citation statements)

References 83 publications

(251 reference statements)

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“…For example, patients may have low expectations of what treatment can achieve, 19 have concerns about taking inhalers and use of inhaled corticosteroids or believe they are only needed intermittently. 20 21 In addition, there is evidence that patients would prefer to take a combined preventer and reliever inhaler in response to symptoms over a daily preventer inhaler with a reliever inhaler for symptom relief. 22 …”

Section: Introductionmentioning

confidence: 99%

Patient preferences for asthma management: a qualitative study

et al. 2020

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ObjectivePreference for asthma management and the use of medications is motivated by the interplay between lived experiences of asthma and patients’ attitudes towards medications. Many previous studies have focused on individual aspects of asthma management, such as the use of preventer and reliever inhalers. The aim of this qualitative study was to explore the preferences of patients with mild-moderate asthma for asthma management as a whole and factors that influenced these preferences.DesignA qualitative study employing qualitative descriptive analysis situated within a constructionist epistemology to analyse transcribed audio recordings from focus groups.SettingThree locations within the greater Wellington area in New Zealand.ParticipantsTwenty-seven adults with self-reported doctor’s diagnosis of asthma, taking short-acting beta-agonists alone or inhaled corticosteroids with or without long-acting beta2-agonist, who had used any inhaled asthma medication within the last month.ResultsFour key areas described preferences for asthma management. Preferences for self-management: participants wanted to be in control of their asthma and developed personal strategies to achieve this. Preferences for the specific medications or treatment regimen: participants preferred regimens that were convenient and reliably relieved symptoms. Preferences for inhaler devices: devices that had dose counters and were easy to use and portable were important. Preferences for asthma services: participants wanted easier access to their inhalers and to be empowered by their healthcare providers. Participant preferences within each of these four areas were influenced by the impact asthma had on their life, their health beliefs, emotional consequences of asthma and perceived barriers to asthma management.ConclusionsThis study illustrates the interaction of the lived experience of asthma, factors specific to the individual, and factors relating to asthma treatments in shaping patient preferences for asthma management. This aids our understanding of preferences for asthma management from the patient perspective.Trial registration numberAustralian New Zealand Clinical Trials Registry (ACTRN12619000601134).

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Section: Introductionmentioning

confidence: 99%

Patient preferences for asthma management: a qualitative study

et al. 2020

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“…Adherence to medication is complex and affected by multiple factors (10)(11)(12). Non-adherence is caused by a combination of unintentional (related to practical barriers) and intentional (related to motivation and beliefs) barriers to take medication (5).…”

Section: Introductionmentioning

confidence: 99%

Asthma control and quality of life in adolescents: The role of illness perceptions, medication beliefs, and adherence

et al. 2019

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Objective: Asthma control and quality of life (QoL) are important disease outcomes for asthma patients. Illness perceptions (cognitive and emotional representations of the illness) and medication beliefs have been found to be important determinants of medication adherence, and subsequently disease control and QoL in adults with asthma. In adolescents, this issue needs further elucidation. Therefore, the aim of this study was to explore the relationship between illness perceptions, medication beliefs, medication adherence, disease control, and QoL in adolescents with asthma. Methods: In this cross-sectional study, we used baseline data of adolescents with asthma (age 12-18 years) who participated in the ADolescent Adherence Patient Tool (ADAPT) study. Questionnaires were administrated online, and included sociodemographic variables and validated questionnaires measuring self-reported illness perceptions, medication beliefs, medication adherence, disease control, and QoL. Results: Data of 243 adolescents with asthma were available; age 15.1 ± 2.0 years and 53% females. More than half of these adolescents (62%; n ¼ 151) reported to be non-adherent (Medication Adherence Report Scale 23) and 77% (n ¼ 188) had uncontrolled asthma. There was a strong positive correlation between disease control and QoL (r ¼ 0.74). All illness perceptions items were correlated with disease control and QoL, with the strongest correlation between 'identity' (symptom perception) and QoL (r¼-0.66). Medication adherence was correlated to medication beliefs (r ¼ 0.38), disease control (r ¼ 0.23), and QoL (r ¼ 0.14), whereas medication beliefs were only associated with adherence. Conclusions: Stimulating positive illness perceptions and medication beliefs might improve adherence, which in turn might lead to improved disease control and better QoL.

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“…Indeed, a review on adherence in autoimmune conditions also concluded that economic, demographic, and clinical characteristics were only moderately linked to adherence or persistence (21). The ndings on the prospective association of beliefs about medication with adherence and persistence in medication taking is congruent with previous work in other conditions (37)(38)(39). Still, beliefs about medication were scarcely studied among PwMS; the only study that examined adherence to DMTs was cross-sectional and found no association between medication beliefs and adherence (13).…”

Section: Discussionmentioning

confidence: 57%

Personal Health Perceptions as Predictors to Medication Adherence in a Prospective Cohort Study Among Patients with Multiple Sclerosis

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Glass-Marmor

Wolkowitz

et al. 2020

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Background: Though adherence to disease-modifying therapies (DMTs) among persons with multiple sclerosis (PwMS) varies and is often below 80%, only few prospective studies on adherence examined predictors beyond demographic and clinical characteristics. Objectives: Identify antecedents to adherence and persistence in a prospective design among PwMS.Methods: PwMS (n=186) were prospectively assessed at three time points: baseline, 6 and 12 months later. Clinical, demographic information and patient-reported medication beliefs, illness perceptions, medication habits, perceived health and affect were assessed. Adherence and persistence were assessed by a combination of self-reports and retrospective review of medication claims. Findings: PwMS were 69.9% (Time 1) and 71% (Time 2) adherent to their DMTs and 64.5.9% were persistent. Beliefs about Medications were consistently predictive at both time points (baseline to Time 1 and Time 1 to Time 2) of medication adherence and persistence whereas other perceptions were predictive at some analyses; clinical and demographic characteristic were mostly not predictive of adherence nor persistence. The prospective association of beliefs about medication with adherence held also in multivariate analyses.Conclusions: Adherence and persistence are predicted by medication beliefs of PwMS. As medication beliefs are modifiable, they should be assessed periodically and targeted as a focus of tailored interventions aimed to improve adherence and consequently health outcomes in PwMS.

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

Cited by 51 publications

References 83 publications

Patient preferences for asthma management: a qualitative study

Patient preferences for asthma management: a qualitative study

Asthma control and quality of life in adolescents: The role of illness perceptions, medication beliefs, and adherence

Personal Health Perceptions as Predictors to Medication Adherence in a Prospective Cohort Study Among Patients with Multiple Sclerosis

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