PRS8 The Effect of Asthma on Health Status, Work Productivity, and Health Care Resource Use in Urban China

Abstract

Non-adherence to a prescribed therapeutic program is an issue in the treatment of chronic diseases more so for asthma, in which the lack of symptoms may be interpreted as remission and beliefs about inhaled corticosteroid (ICS) could also result in non-adherence. The objective of the study was to analyse the self-reported adherence to ICS therapy and beliefs about medicine. METHODS: Adult patients previously diagnosed with asthma and who were prescribed ICS, visiting emergency room of a tertiary care public chest hospital for asthma exacerbation were recruited (March 2008-December 2009). Patients completed self-reported questionnaire containing 49 questions on six domains: socio-demographic, clinical profile, causal belief, self-report on adherence, beliefs about medicines and medication adherence report scale (MARS) after stabilization. RESULTS: Of the 200 patients, 51.5% were between 30-40 years, 64% were female, mean duration of asthma was 10.5Ϯ8.1 years and 51.5% were having severe asthma. Salient findings on self-report adherence were, 49% reported that they took ICS even if asymptomatic; 91% reported that they forgot to take their ICS some or most of the times; 84% reported that they avoided ICS some of the times. In response to individual item for MARS, 15.5% claimed that they took ICS as prescribed. Significant positive correlation was observed between treatment necessity and reported adherence (rϭ0.445, p Ͻ 0.001). Patients who were concerned for the potential effects and risk of dependence had low adherence with significantly negative correlation. Younger age group had a significant correlation with social inhibition and female gender correlated significantly with fear of adverse effects and social inhibition as the cause for avoiding ICS. CONCLUSIONS: The findings support the model of treatment adherence, which incorporated beliefs about treatment as well as illness perceptions. The necessary-concerns offer a potentially useful framework to help clinicians elicits key treatment beliefs influencing adherence to ICS.