Patient factors and compliance with asthma therapy

Abstract

Compliance by patients to prescribed treatment regimens can be considered as the interface between effective therapy and effective disease management. Compliance can be affected by the nature of the relationship between the practitioner and the patient, and their attitudes towards each other. It has also been suggested that practitioner behaviour can influence patient behaviour and health status. However, each individual patient is influenced in his or her attitudes, and reactions to disease and its management, by a wide variety of patient-related factors. These include psychological variables such as mood, beliefs, and the knowledge, motivation and ability of the patient. Social factors may also play a role: these include age, marital and socioeconomic status and level of education. Results from a range of studies in patients with pulmonary or other diseases show that the psychosocial determinants of compliance are only poorly understood, and suggest that compliance cannot be predicted from patients' health status and that social factors are weak indicators only. Furthermore, it appears from available data that patients' beliefs about health issues are not as useful as indicators of likely compliance as was previously believed.

Factors Affecting Drug Compliance in Paediatric Asthma

“…Being educated about various aspects of asthma such as understanding the requirement of long term and possibly a cumbersome treatment and being aware of the side effects of the drugs was noted in the compliant patient group which was in concordance with other studies 5,18,19 . This was attributed to the fact that asthma education signifi cantly increases the comprehension of medications and active participation of patients in treatment 25 .…”

“…It is suggested that the better compliance in elder children could be due to the fact that they were more expressive of their symptoms. Mother's academic education did not have any infl uence on the compliance of patient in this study, which is also brought out in other studies 5,18 . Di Metteo stated that even patients with high educational qualifi cations may not comprehend the benefi ts and necessity of adhering to a treatment 24 .…”

“…Socioeconomic status and level of education markedly infl uences the way in which patients takes his treatment 19 . While Malou Lindberg et al found that females were more compliant than males but we did not fi nd any gender predilection affecting compliance in this study 18 . Results similar to this study were reported by Rifat et al and Clarke et al 5,19 .…”

“…This could be due to a random selection of patients. In this study the compliance was 47 percent compared to the 49% and 53% in study be Nizar Rifat et al and Malou Lindberg et al 5,18 . The results did not differ much from the patients in both developing and developed countries.…”

“…Drug levels can be monitored giving an accurate result but is prohibitively expensive in a developing country 17 . Three studies dealing with compliance in adult asthmatics done in Egypt, Sweden and USA have used questionnaires to decide the patient compliance 5,18,19 . A scale known as modifi ed Morirsky scale which scored the, 'yes' and 'no' answers to determine compliance was also used 5 .…”