Symptom perception and adherence to asthma controller medications.
OBJECTIVE
To explore asthma symptom perception and the relationship between asthma symptom perception and adherence to asthma treatment.


METHODS
Adult patients (N=120) of asthma/allergy specialty clinics, taking Advair as a controller medication, were enrolled in this cross-sectional descriptive study.


METHODS
Ninety-seven participants completed 4 weeks of daily diaries to assess subjective symptom perception and measured peak expiratory flow rates (PEFR), both done twice daily. Individual perceptual accuracy scores (PAS) were determined by correlating the subjective symptom perception scores with the PEFRs. Measures included demographic variables, illness identity (personal control and treatment control, consequences, and timeline-cyclical subscales of the IPQ-R), asthma severity (FEV1 percentage) and a single-item indicator of perceived asthma severity. Adherence was measured by the Medication Adherence Report Scale (MARS) and by an Advair dose count (percentage of doses taken as prescribed).


RESULTS
Independent t tests comparing adherence rates of good versus poor perceivers were not significant, using either the percentage Advair dose count or the MARS. Multiple regression analyses showed that years with asthma, illness identity, and peak flow variability were all significant explanatory variables for perceptual accuracy.


CONCLUSIONS
Peak flow variability adds complexity to the relationship between perceptual accuracy and adherence that warrants further investigation.
Ohm
Ruth
R
Baker University School of Nursing, Stormont-Vail HealthCare, Topeka, KS, USA. ruthohm@hotmail.com
Aaronson
Lauren S
LS
D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000420:Albuterol / Q000031:analogs & derivatives / Q000627:therapeutic use; D000730:Androstadienes / Q000627:therapeutic use; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use*; D001249:Asthma / Q000150:complications / Q000188:drug therapy* / Q000523:psychology*; D001364:Awareness; D003430:Cross-Sectional Studies; D004338:Drug Combinations; D004417:Dyspnea / Q000175:diagnosis / Q000209:etiology / Q000523:psychology; D005260:Female; D000068297:Fluticasone-Salmeterol Drug Combination; D005541:Forced Expiratory Volume; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007389:Internal-External Control; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D015404:Nursing Methodology Research; D010349:Patient Compliance / Q000523:psychology*; D010353:Patient Education as Topic; D010366:Peak Expiratory Flow Rate; D012044:Regression Analysis; D012648:Self Care / Q000379:methods / Q000523:psychology; D012649:Self Concept; D012720:Severity of Illness Index; D012803:Sick Role; D011795:Surveys and Questionnaires
D000730:Androstadienes; D018927:Anti-Asthmatic Agents; D004338:Drug Combinations; D000068297:Fluticasone-Salmeterol Drug Combination; D000420:Albuterol