Alexandra L. Dima|Gimena Hernández|Oriol Cunillera|Montse Ferrer|Marijn de Bruin
Asthma inhaler adherence determinants in adults: systematic review of observational data
University of Amsterdam|Universitat Autònoma de Barcelona|Hospital Del Mar|Municipal Institute for Medical Research|Universitat Autònoma de Barcelona|University of Aberdeen|University of Amsterdam
nonadherence inhaled medication leads poor asthma control increased healthcare utilisation many studies exploring adherence determinants conducted summaries evidence scarce performed systematic review observational research determinants asthma inhaler adherence among adults searched articles english reporting quantitative observational studies inhaler adherence correlates among adults developed countries published embase medline psychinfo psycharticles 19902014 two coders independently assessed eligibility extracted data assessed study quality results summarised qualitatively social economic healthcare therapy condition patientrelated factors 51 studies included mainly examined patientrelated factors found consistent links adherence stronger inhalernecessity beliefs possibly older age limited evidence relevance determinants partly due study heterogeneity regarding types determinants examined methodological quality varied considerably studies performed generally poorly definitions variables measures risk bias sample size data analysis broader adoption common methodological standards health behaviour theories needed cumulative science determinants adherence asthma inhalers among adults develop