Nonadherence with the Asthma Regimen

Abstract

Adherence to a clinical regimen is paramount in determining its effectiveness. In asthma it encompasses such components of self-management as avoidance of allergens and irritants, cessation of smoking, making use of individual guidelines to manage exacerbations, keeping scheduled appointments, and contacting the caregiver when appropriate. The average adherence rate with medication in pediatric studies is 48%. In a three-month investigation of adherence by children with asthma, those who suffered an exacerbation had a median adherence rate with inhaled corticosteroid therapy of 13.7%, while those whose disease remained under control had a rate of 68.2%. Factors that influence patients' commitment to their care are knowledge of the disease and its treatment, quality of the interaction between the patient and the provider, patient satisfaction, social and family support, health beliefs and attitudes, and factors associated with the illness and its treatment such as the duration and the complexity of the regimen. Physicians can enhance adherence by accepting responsibility for it while encouraging patients to assume a greater role in their own care.