title: Adolescents' inhaled corticosteroid adherence: the importance of treatment perceptions and medication knowledge.
abstract: BACKGROUND
  Studies measuring inhaled corticosteroid (ICS) adherence frequently report adherence rates below 50%. Although asthma is common in adolescents, few studies have explored determinants of ICS adherence in adolescents. The objective of this study was to examine adherence and related factors in adolescent ICS users.
  
  
  METHODS
  Adolescent ICS users, aged 12-18 years, were randomly recruited from a sample of 94 community pharmacies belonging to the Utrecht Pharmacy Practice Network for Education and Research to complete an online questionnaire. The survey contained questions on asthma control, self-reported adherence, medication beliefs and medication knowledge. Data were collected between April and August 2013.
  
  
  RESULTS
  Complete questionnaire data were received from 182 adolescents of which 40% reported to be adherent. Approximately 40% of the participants perceived strong needs, whilst only 10% was highly concerned about adverse effects regarding their ICS use. Good adherence was significantly associated with asthma control (OR: 2.1, 95% CI: 1.1-4.1). Necessity beliefs and sufficient medication knowledge were associated with better adherence (p < 0.05).
  
  
  CONCLUSIONS
  Our results suggest that by improving knowledge about asthma treatments and stimulating positive perceptions towards medicines, especially regarding the necessity of medication use, better adherence rates might be achieved.
authors.affiliation: Division Pharmacoepidemiology and Clinical Pharmacology, Utrecht Pharmacy Practice Network for Education and Research (UPPER), Utrecht Institute of Pharmaceutical Sciences, Utrecht University , Utrecht , The Netherlands.
authors.forename: Ellen S
authors.initials: ES
authors.lastname: Koster
authors.forename: Daphne
authors.initials: D
authors.lastname: Philbert
authors.forename: Nina A
authors.initials: NA
authors.lastname: Winters
authors.forename: Marcel L
authors.initials: ML
authors.lastname: Bouvy
mesh_terms: D000280:Administration, Inhalation; D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy* / Q000523:psychology*; D002648:Child; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D055118:Medication Adherence / Q000523:psychology*; D010465:Perception
chemical_list: D000305:Adrenal Cortex Hormones
keywords: Adherence; adolescence; asthma; inhaled corticosteroids; knowledge; medication beliefs; pharmacy