SAN DIEGO – When patients do not take their asthma medication, it’s usually because they forgot and not because they intentionally made a change in their treatment regimen, a retrospective study of data on 108 adults and 156 children found.
The role of forgetfulness in nonadherence emphasizes the importance of interventions such as text messages, smart inhalers with reminder systems, or Web-based reminder programs to reduce the risk of exacerbations, Dr. Joyce Xiang Wu Lee said at the annual meeting of the American Academy of Allergy, Asthma, and Immunology.
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Adults and children were more likely to report forgetfulness than intentional nonadherence when failing to take asthma medication.
Dr. Lee, a fellow in allergy and immunology at the Veterans Affairs Greater Los Angeles Medical Center, and her colleagues retrospectively analyzed a subset of data from a previous observational study of the correlation between the Medication Adherence Report ScaleAsthma (MARSA) and other asthma control metrics. They used answers to 10 questions in 283 MARSA surveys completed by the adults (aged 46-77 years) and in 190 MARSA surveys completed by children (aged 4-11 years) during multiple health care visits between June 2010 and May 2011.
The first of the 10 questions asked patients how often they forget to take their asthma medication, and answers were considered indicative of unintentional nonadherence. The other nine questions were used as proxies for intentional nonadherence, including asking how often patients "stop taking it for awhile," "decide to miss a dose," "try to avoid using it," "only use it when I feel breathless," "alter the dose," "use it for a reserve" if other treatments don’t work, "use it before doing something which might make me breathless," "take it less than instructed," or "use it when I need it."
The results suggest that both adult and pediatric patients are more likely to be unintentionally nonadherent to asthma therapy than intentionally adherent, according to statistical analyses using Cronbach’s alpha, nonparametric one-way analysis of variance, and a pairwise comparison using the Bonferroni approach to determine differences between answers to the questions, .
The current analysis excluded patients with chronic obstructive pulmonary disease, other confounding comorbidities, or an inability to perform spirometry or to complete the questionnaire.
Dr. Lee reported having no financial disclosures.
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