E. CHEN1, S.H. TEO2, S.Y. TAN2, W.E. TANG2
NHG Polyclinics1, Others2
Asthma is the most commonly encountered chronic respiratory condition in primary care. Non-adherence to asthma preventer inhalers results in poorer health outcomes. Awareness of factors contributing to non-adherence is useful in the long-term management of asthma patients. We aim to describe asthma preventer inhaler adherence in primary care patients with asthma.
Adult asthma patients on preventer inhalers completed a cross-sectional survey conducted in primary care clinics covering: Beliefs about Medicines Questionnaire (BMQ), illness perception, asthma knowledge, duration of asthma, asthma severity, type and dose of asthma inhalers, socio-demographic variables and Medication Adherence Report Scale-Asthma (MARS-A). Participants were categorised into 4 attitudinal groups: accepting, ambivalent, indifferent and sceptical based on BMQ scores. Relationship between adherence and contributory factors was analysed using multivariable logistic regression.
Response rate was 50.4% (478 of 948 eligible patients completed the survey). Self-reported preventer inhaler adherence rate was 44.0%. Adherence was significantly associated with inhaled combination therapy use, attitudinal groups, higher asthma knowledge scores and lower illness perception scores. Patients on combination therapy were 1.6 times [OR 1.61, 95%CI 1.08-2.40] more likely to be adherent compared to those on inhaled corticosteroid monotherapy. Compared to those in the accepting attitudinal group, patients in indifferent and sceptical attitudinal groups were less likely to be adherent [OR 0.49, 95%CI 0.31-0.78] and [OR 0.33, 95%CI 0.16-0.68] respectively.
Preventer inhaler adherence amongst primary care patients with asthma is low. Targeted interventions addressing patients’ beliefs about medications, illness perception, asthma knowledge and type of preventer inhaler may improve preventer inhaler adherence.