Adherence and Nonadherence to Inhaled Corticosteroids in Asthma Patients; Factors and Consequences

Objectives:Asthma is one of the commonest chronic illnesses worldwide. Inhaled corticosteroids (ICS) are criticalcomponents in this disease therapy. Incompliance to prescribed treatment is a major factor leading to poor asthmacontrol and many factors could be responsible for this issue.Our aim is to clarify the relation between adherence totreatment and level of asthma control and to evaluate the role of some factors affecting the compliance of asthmaticpatients to prescribed inhaled corticosteroids (ICS).Subjects and methods;A prospective descriptive study was held at internal medicine, thoracic medicine, andpediatric clinics located at Prince Rashed Hospital (PRH), North of Jordan, on asthmatic patients over a period of sixmonths starting from 15 July 2014. Factors that may affect adherence to therapy were studied. These factorsincluded age, sex, residence; level of education, asthma education, Type of inhalation device, and combinations withlong acting β2 agonist (LABA).A structured questionnaire to collect the data was used. Adherence to ICS wasdetermined according toModified Morisky Scale (MMS).Global Initiative for Asthma (GINA) 2011 guidelines wereused to assess the level of asthma control. For statistical analysis SPSS window software was used. P- Value below0.05 was considered as significant.Results:Total of 110 asthmatic patients, of them 50 (45%) males, were included in the study.53 patients (48%) wereadherent and only 10patients (9%) have a fully controlled asthma. Adherent patients are more likely to havecontrolled asthma. Adherence was significantly promoted by increased level of education, being older, havingasthma education, using dry powder inhaler (DPI), and using ICS and LABA by the same device. On other hand, sexand residence have no significant effect on adherence.Conclusion:Nonadherence to ICS is prevalent and it is significantly worsening the clinical outcome in asthmaticpatients. National efforts are mandatory to improve the knowledge of general population about such chronic andcorrectable illnesses as bronchial asthma in order to increase the adherence to treatment and improve the outcome ofthese diseases.

Keywords:

Bronchial asthma , Inhaled Corticosteroids , Compliance , Prince Rashed Hospital , North of Jordan