Journal of Emergency Health Care
Formerly known as: International Journal of Medical Investigation
Volume 4, Issue 1 (march 2015)
J Emerg Health Care 2015, 4(1): 173-179 |
Back to browse issues page
Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
AL-Jamal M, AObeidat L, AL-Huneity S Z, Al-haji M, Tawalbeh A. Adherence and Nonadherence to Inhaled Corticosteroids in Asthma Patients Factors and Consequences.. J Emerg Health Care 2015; 4 (1) :173-179
URL: http://intjmi.com/article-1-97-en.html
URL: http://intjmi.com/article-1-97-en.html
MD,JB,senior specialist,department of Internal Medicine,Jordanian Royal Medical Service(JRMS).
Abstract: (12588 Views)
Abstract Objectives:Asthma is one of the commonest chronic illnesses worldwide. Inhaled corticosteroids (ICS) are critical components in this disease therapy. Incompliance to prescribed treatment is a major factor leading to poor asthma control and many factors could be responsible for this issue.Our aim is to clarify the relation between adherence to treatment and level of asthma control and to evaluate the role of some factors affecting the compliance of asthmatic patients to prescribed inhaled corticosteroids (ICS). Subjects and methodsA prospective descriptive study was held at internal medicine, thoracic medicine, and pediatric clinics located at Prince Rashed Hospital (PRH), North of Jordan, on asthmatic patients over a period of six months starting from 15 July 2014. Factors that may affect adherence to therapy were studied. These factors included age, sex, residence level of education, asthma education, Type of inhalation device, and combinations with long acting β2 agonist (LABA).A structured questionnaire to collect the data was used. Adherence to ICS was determined according toModified Morisky Scale (MMS).Global Initiative for Asthma (GINA) 2011 guidelines were used to assess the level of asthma control. For statistical analysis SPSS window software was used. P- Value below 0.05 was considered as significant. Results:Total of 110 asthmatic patients, of them 50 (45%) males, were included in the study.53 patients (48%) were adherent and only 10patients (9%) have a fully controlled asthma. Adherent patients are more likely to have controlled asthma. Adherence was significantly promoted by increased level of education, being older, having asthma education, using dry powder inhaler (DPI), and using ICS and LABA by the same device. On other hand, sex and residence have no significant effect on adherence. Conclusion:Nonadherence to ICS is prevalent and it is significantly worsening the clinical outcome in asthmatic patients. National efforts are mandatory to improve the knowledge of general population about such chronic and correctable illnesses as bronchial asthma in order to increase the adherence to treatment and improve the outcome of these diseases.
Keywords: Bronchial asthma, Inhaled Corticosteroids, Compliance, Prince Rashed Hospital, North of Jordan
References
1. 1.Cochrane MG, Bala MV, Downs KE, Mauskopf J, Ben Joseph RH.Inhaled corticosteroids for asthma therapy: patient compliance, devices,and inhalation technique. Chest 2000;117:542-50.
2. Stephenson BJ, Rowe BH, Haynes RB, Macharia WM, Leon G. The rational clinical examination: is this patient taking the treatment as prescribed. JAMA 1993;269:2779-81.
3. Bender B, Milgrom H, Rand C. Nonadherence in asthmatic patients: is there a solution to the problem? Ann Allergy Asthma Immunol 1997;79:177-85.
4. Watts RW, McLennan G, Bassham I, el Saadi O. Do patients with asthma fill their prescriptions? a primary compliance study. Aust Fam Physician 1997;26(suppl 1):S4-6.
5. Bronstein JM, Santer L, Johnson V. The use of Medicaid claims as a sup plementary source of information on quality of asthma care. J Healthc Qual 2000;22:13-8.
6. Apter AJ, Boston RC, George M, Norfleet AL, Tenhave T, Coyne JC, et al. Modifiable barriers to adherence to inhaled steroids among adults with asthma: it’s not just black and white. J Allergy Clin Immunol 2003;111:1219-26.
7. Williams LK, Joseph CL, Peterson EL, Moon C, Xi H, Krajenta R, et al. Race-ethnicity, crime, and other factors associated with adherence to inhaled corticosteroids. J Allergy Clin Immunol 2007;119:168-75 .
8. Long-term effects of budesonide or nedocromil in children with asthma. The Childhood Asthma Management Program Research Group. N Engl J Med 2000; 343:1054-63.
9. Williams LK, Pladevall M, Xi H, Peterson EL, Joseph C, Lafata JE, et al. Relation ship between adherence to inhaled corticosteroids and poor outcomes among adults with asthma. J Allergy Clin Immunol 2004;114:1288-93.
10. Boushey HA, Sorkness CA, King TS, Sullivan SD, Fahy JV, Lazarus SC, et al. Daily versus as-needed corticosteroids for mild persistent asthma. N Engl J Med 2005;352:1519-28 12.
11.DiMatteo MR, Giordani PJ, Lepper HS, Croghan TW. Patient adherence and medical treatment outcomes: a meta-analysis. Med Care 2002;40: 794-811.
12. Charles H, Good CB, Hanusa BH, Chang CC, Whittle J. Racial differences in adherence to cardiac medications. J Natl Med Assoc 2003;95:17-27
13. Pladevall M, Williams LK, Potts LA, Divine G, Xi H, Lafata JE. Clinical outcomes and adherence to medications measured by claims data in patients with diabetes. Diabetes Care 2004;27:2800-5.
14. Schroeder K, Fahey T, Ebrahim S, Peters TJ. Adherence to long-term therapies: recent WHO report provides some answers but poses even more questions. J Clin Epidemiol 2004;57:2-3.
15. Deyo RA, Cherkin DC, Ciol MA. Adapting a clinical comorbidity index for use with ICD-9-CM administrative databases. J Clin Epidemiol 1992; 45:613-9.
16. SAS Institute Inc. SAS/STAT Users Guide. Version 8. Cary (NC): SAS Institute, Inc; 1999.
| Rights and permissions | |
 |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |