Is there any way to improve adherence to asthma controller therapy?

May 1, 2007

Nonadherence with asthma controller medication is a common problem that increases the risk of asthma-related hospitalizations and emergency department visits. Although strategies to improve adherence have often been unsuccessful, it is clear that engaging patients in asthma self-management is one of the keys.

Nonadherence with asthma controller medication is a common problem that increases the risk of asthma-related hospitalizations and emergency department visits. Although strategies to improve adherence have often been unsuccessful, it is clear that engaging patients in asthma self-management is one of the keys.

Bender and associates conducted a telephone survey of 200 adults with asthma who were randomly selected from a national database. The participants were asked about their medication use, treatment preferences, and barriers to adherence. Most of the participants had histories that suggested they had at least moderate to severe persistent asthma. Many of them had inadequately controlled asthma. Close to 50% found it necessary to restrict their physical exercise, and one third had used their inhaled ß2-agonist 2 or more times in the previous week.

The study found that adherence to daily controller medication was considerably below the prescribed level. The cost of medication was identified as one of the barriers to adherence (Table). Most of the participants said they would like to be more in control of their treatment and that they would like treatment to be more immediately effective and longer-lasting. However, they did not think that inadequate information was a barrier to adherence.

The authors say that their findings support the importance of developing asthma treatment plans that encourage patients to have more control over their use of asth- ma medications.