title: Personality and unachieved treatment goals related to poor adherence to asthma medication in a newly developed adherence questionnaire - a population-based study.
abstract: BACKGROUND
  Health-care professionals have a responsibility to be attentive to patients' adherence behavior but it could be difficult to identify poor adherence in the context of clinical practice. Assessment of personality could be used to identify individuals who are in need for support with their adherence behavior. To our knowledge, existing adherence questionnaires are not based on individuals reflecting asthmatics in the general population and there is limited research describing adherence with asthma medication in relation to personal goals with the treatment. The aim was to develop and validate an adherence questionnaire in adult individuals with asthma from the general population and to assess adherence in relation to personality traits and goals with the asthma medication using the developed questionnaire.
  
  
  METHODS
  The study was conducted in three phases: 1. A preliminary postal 46-item questionnaire was refined after psychometric testing (n= 157). 2. The questionnaire was validated (n= 104). 3. The developed adherence questionnaire was analyzed in relation to personality traits and achieved goals with the asthma medication. Adult respondents with physician diagnosed asthma using asthma medications were selected from the population-based West Sweden Asthma Study. The respondents completed the Neuroticism, Extraversion and Openness to Experience Five-Factor Inventory and the Medication Adherence Report Scale and stated their goals with the asthma medication. Data were analyzed using t-tests, correlations, multiple regression and principal component analysis.
  
  
  RESULTS
  A final questionnaire was developed consisting of ten items organized in three subscales - "medication routines", "self-adjusting the medication" and "concerns about side-effects". Two of the subscales - "medication routines" and "self-adjusting the medication" - were associated with the Medication Adherence Report Scale. The subscale "medication routines" was associated with the personality traits - Conscientiousness and Neuroticism and unachieved goals with the asthma medication.
  
  
  CONCLUSIONS
  The developed questionnaire appears to be useful for measuring adherence to asthma medication in adult individuals with asthma. The study suggests that both individual differences and personal treatment goals need to be addressed in efforts to promote adherence to asthma medication treatment.
authors.affiliation: Krefting Research Centre, Institute of Medicine, Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg, Box 424, SE-405 30 Gothenburg, Sweden ; Department of Care Science, Faculty of Health and Society, Malmö University, Jan Waldenströms gata 25, SE-205 06 Malmö, Sweden.
authors.forename: Malin
authors.identifier: 0000-0001-5493-8334
authors.initials: M
authors.lastname: Axelsson
authors.affiliation: Krefting Research Centre, Institute of Medicine, Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg, Box 424, SE-405 30 Gothenburg, Sweden.
authors.forename: Linda
authors.initials: L
authors.lastname: Ekerljung
authors.affiliation: Krefting Research Centre, Institute of Medicine, Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg, Box 424, SE-405 30 Gothenburg, Sweden.
authors.forename: Bo
authors.initials: B
authors.lastname: Lundbäck
authors.affiliation: Krefting Research Centre, Institute of Medicine, Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg, Box 424, SE-405 30 Gothenburg, Sweden.
authors.forename: Jan
authors.initials: J
authors.lastname: Lötvall
keywords: Medication adherence; Patient compliance; Population-based study; Respiratory tract disease; Self-report