Factors affecting adherence to asthma treatment in an international cohort of young and middle-aged adults.
BACKGROUND
A major reason of the poor control of asthma is that patients fail to adhere to their treatment. The aim of the study was to identify factors affecting changes in asthma treatment adherence in an international cohort.


METHODS
A follow-up study was carried out by means of a structured clinical interview in 971 subjects with asthma from 12 countries who participated in both the European Community Respiratory Health Survey: ECRHS-I (1990-94) and ECRHS-II (1998-2002). Subjects were considered adherent if they reported they normally took all the prescribed drugs. A logistic model was used to study the adjusted effect of the determinants.


RESULTS
The net change in adherence to anti-asthmatic treatment per 10 years of follow-up was -2% (95% CI: -9.5, 5.5), 7.5% (-2.6, 17.6), 15.0% (6.6, 23.5) and 19.8% (4.1, 35.5), respectively, in Nordic, Mediterranean, Continental and extra-European areas. Among the 428 non-adherent subjects in ECRHS-I, having regular consultations with health care professionals was the strongest predictor of increased adherence (OR 3.32; 95% CI: 1.08-10.17). Among the 543 adherent subjects in ECRHS-I, using inhaled corticosteroids significantly predicted a persistence of adherence (OR 2.04; 95% CI: 1.11-3.75). No effect of gender, age, duration of the disease, smoking habit and educational level was observed.


CONCLUSIONS
Our findings highlight the key role of doctors and nurses in educating and regularly reviewing the patients and support the efforts for an improvement of clinical communication.
Corsico
Angelo G
AG
Division of Respiratory Diseases, Fondazione IRCCS Policlinico S. Matteo, University of Pavia, via Taramelli 5, 27100 Pavia, Italy. angelo.corsico@unipv.it
Cazzoletti
Lucia
L
de Marco
Roberto
R
Janson
Christer
C
Jarvis
Deborah
D
Zoia
Maria C
MC
Bugiani
Massimiliano
M
Accordini
Simone
S
Villani
Simona
S
Marinoni
Alessandra
A
Gislason
David
D
Gulsvik
Amund
A
Pin
Isabelle
I
Vermeire
Paul
P
Cerveri
Isa
I
D000328:Adult; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D001249:Asthma / Q000188:drug therapy* / Q000523:psychology; D004812:Epidemiologic Methods; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D010349:Patient Compliance; D018579:Patient Selection
D018927:Anti-Asthmatic Agents; D005938:Glucocorticoids