Role of health education and self-action plan in improving the drug compliance in bronchial asthma

Abstract

Background:Considering the prevalence and associated burden of disease due to bronchial asthma, it is mandatory to obtain an optimal control of the disease and to improve outcomes for these patients. But it has been observed that there is very poor adherence to the inhalational therapy which leads to the suboptimal control of the disease.Objectives of the Study:To study the adherence for aerosol therapy in bronchial asthma patients and to assess the impact of health education and self-action plan in improving the compliance to the therapy.Methodology:A prospective study was done in a total of 500 bronchial asthma patients over a period of 2 years. Once included in the study, the patients were followed-up for a total of 12 weeks for calculation of nonadherence to the aerosol therapy. In nonadherent patients, we employed various health education strategies to improve the compliance in these cases.Results:A total of 500 patients of bronchial asthma who were started on aerosol therapy over duration of 2 years were included in the study. At the end of 12 weeks, it was observed that, only 193 patients (38.6%) had regular compliance and 307 patients (61.4%) were noncompliant to aerosol therapy as prescribed for bronchial asthma. Factors that were associated with poor compliance were: Lower educational level status, poor socioeconomic status, cumbersome regimens, dislike of medication, and distant pharmacies. Nondrug factors that reduced the compliance were: Fears about side effects, anger about condition or its treatment, forgetfulness or complacency, and patient's ill attitudes toward health. After employing the various strategies for improving the compliance in these patients, the compliance increased in 176 patients (57.3%) among the earlier defaulted patients, while the remaining 131 patients (42.7%) were found to be noncompliant even after various educational techniques.Conclusion:Noncompliance in asthma management is a fact of life and no single compliance improving strategy probably will be as effective as a good physician-patient relationship. Optimal self-management allowing for optimization of asthma control by adjustment of medications may be conducted by either self-adjustment with the aid of a written action plan or by regular medical review. Individualized written action plans based on peak expiratory flow are equivalent to action plans based on symptoms.

Assessment of Knowledge and Attitude of Bronchial Asthma Patients Towards Their Disease

“…It clearly shows that a better understanding of attitudes towards asthma medication should be helpful in encouraging good patient adherence to treatment. 9 It was found that the attitudes of peers towards asthma patients were clearly different from those of the other members in the family. This will lead to anxiety and depression among asthma patients and thus, affecting the compliance to the medications.…”

“…Educational methods tailored to needs of each patient and effective behavior towards disease and its management is very essential. In one of our study 9 it was shown that with various tools of education, the compliance in medications could be increased by almost another 40%.…”

“…Education has been cited as an important component of any asthma management strategy, by improving asthma knowledge and changing behavior. 9 Knowledge, attitudes, and beliefs of the patients towards bronchial asthma are recognized as being major determinants of health behavior. Currently there is little awareness about asthma in most of the developing countries, including India.…”

Assessment of Knowledge and Attitude of Parents Towards the Allergy and Bronchial Asthma in Their Children

“…Other concerns voiced by the parents were the cost of inhaled medication and difficulty in using inhalers. 26 Recently, Gaude et al 27 has observed that the compliance in bronchial asthma patients was just about 38.6%, and even after health education it improved by another 40%. Hence it is not only the responsibility of the parents, but also the treating physicians should be responsible for proper education regarding the inhalational therapy in bronchial asthma.…”

Why don’t patients take their analgesics? A meta-ethnography assessing the perceptions of medication adherence in patients with osteoarthritis

“…Through this, understanding of various strategies must be tailored and individualised to have a meaningful impact on medication adherence. Such a recommendation has been seen within the medication adherence literature in hypertension [22], asthma [23] and depression [24]. However, this understanding is particularly valid in the osteoarthritis population given the acknowledged variability in health beliefs regarding the condition itself, irrespective of beliefs surrounding pharmacological management [25].…”