Juliet Foster|Lorraine Smith|Sinthia Bosnic?Anticevich|Tim Usherwood|Susan ? Sawyer|Cynthia S. Rand|Helen K. Reddel
Identifying patient?specific beliefs and behaviours for conversations about adherence in asthma
Woolcock Institute of Medical Research|University of Sydney|Western Sydney University|University of Sydney|Royal Children's Hospital|University of Melbourne|Murdoch Children's Research Institute|Johns Hopkins University|Woolcock Institute of Medical Research|University of Sydney
abstract background asthma guidelines advise addressing adherence every visit simple tools exist assist clinicians identifying key adherencerelated beliefs behaviours individual patients aims identify potentially modifiable beliefs behaviours predict electronically recorded adherence controller therapy methods patients aged 14 years doctordiagnosed asthma prescribed inhaled corticosteroidlongacting 2 agonist icslaba completed questionnaires medication beliefsbehaviours sideeffects morisky adherence behaviour score asthma control test act recorded spirometry adherence icslaba measured electronically 8 weeks predictors adherence identified univariate multivariate analyses results 99100 patients completed study 57 female forced expiratory volume 1 mean standard deviation 83 23 predicted act 199 38 mean electronically recorded adherence n 85 75 25 mean selfreported adherence 85 26 factor analysis questionnaire items significantly associated poor adherence identified seven themes perceived necessity safety concerns acceptance asthma chronicitymedication effectiveness advice friendsfamily motivationroutine ease use satisfaction asthma management morisky score moderately associated actual adherence r 045 p lt 00001 regression analysis 10 items independently predicted adherence adjusted r 2 067 p lt 0001 opinions friendsfamily patients medication use strongly associated poor adherence global concerns icslaba therapy predictive poor adherence specific sideeffects onethird patients reported experiencing sideeffects steroid inhaler lower adherence others mean 62 vs 81 p 0015 conclusions study identified several specific beliefs behaviours clinicians could use initiating patientcentred conversations medication adherence asthma