title: The Seven Stages of Man: The Role of Developmental Stage on Medication Adherence in Respiratory Diseases.
abstract: The circumstances and drivers of the decision to initiate, implement, or persist with a medication differ for individuals at each developmental stage. For school-age children with asthma, the social environment of their family's cultural beliefs and the influence of peer networks and school policies are strong determinants of medication adherence. The stage of adolescence can be a particularly challenging time because there is a reduction in parental supervision of asthma management as the young person strives to become more autonomous. To illustrate the importance of such factors, adherence interventions in children and young adults with asthma have used peer-based supports and social supports, particularly social media platforms. In older patients, it is internal rather than external factors and age-related decline that pose challenges to medication adherence. Seniors face the challenges of polypharmacy, reduced social support, increased isolation, and loss of cognitive function. Strategies to promote adherence must be tailored to the developmental stage and respective behavioral determinants of the target group. This review considers the different attitudes toward medication and the different adherence behaviors in young and elderly patients with chronic respiratory conditions, specifically asthma and chronic obstructive pulmonary disease. Opportunities to intervene to optimize adherence are suggested.
authors: Department of Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland. Electronic address: rcostello@rcsi.ie.
authors: Richard W
authors: RW
authors: Costello
authors: Clinical Management Group, Woolcock Institute of Medical Research, University of Sydney, Sydney, Australia.
authors: Juliet M
authors: JM
authors: Foster
authors: Blizard Institute, Queen Mary University London, London, United Kingdom.
authors: Jonathan
authors: J
authors: Grigg
authors: Division of Pulmonary and Critical Care Medicine, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Md.
authors: Michelle N
authors: MN
authors: Eakin
authors: Allergy and Respiratory Diseases Clinica, DIMI Department of Internal Medicine, University of Genoa, IRCCS AOU San Martino-IST, Genoa, Italy.
authors: Walter
authors: W
authors: Canonica
authors: Faculty of Medicine, Department of Pulmonology and Respiratory Medicine, University of Indonesia, Persahabatan Hospital, Rawamangun, Jakarta, Indonesia.
authors: Fasail
authors: F
authors: Yunus
authors: Allergy and Respiratory Research Group, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, United Kingdom.
authors: Dermot
authors: D
authors: Ryan
mesh_terms: D000375:Aging / Q000523:psychology; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use; D006282:Health Personnel; D006803:Human Development; D006801:Humans; D008171:Lung Diseases / Q000188:drug therapy* / Q000523:psychology; D055118:Medication Adherence / Q000523:psychology; D011369:Professional-Patient Relations; D012944:Social Support
chemical_list: D018927:Anti-Asthmatic Agents
keywords: Adolescents; Childhood asthma; Cognitive impairment; Elderly patients; Implementation; Initiation; Medication adherence; Persistence