The Patient's Perspective: Adherence or Non-adherence to Asthma Controller Therapy?

Abstract

Both accidental and intentional non-adherence with controller therapy is common among adult asthmatics. The reasons for suboptimal adherence seem to be accessible through education of both patients and caregivers.

Use of Online Self-Management Diaries in Asthma and COPD: A Qualitative Study of Subjects' and Professionals' Perceptions and Behaviors

“…with me, the scores are always stable: 1.7, 1.6, 1. management diaries, reasons such as the format is too rigid and preference for face-to-face contact have not been previously described. The reasons for using self-management diaries expressed by subjects are not found in earlier research, 11 which might be due to the small number of studies on this topic. Although subjects and professionals experienced several positive aspects in using the self-management diaries, a number of factors preclude their optimal and widespread use.…”

“…The majority of reasons for nonuse expressed by subjects are described in earlier research on self-management strategies. [11][12][13][14] Because little research has been conducted specifically on the reasons for not using self- Too difficult to use "I couldn't access the web site very easily, and I couldn't handle the computer very well, so it ͓filling in the self-management diary͔ took me a couple of days." (COPD subject S) No acknowledgement of the disease "I don't acknowledge my disease; I try to cope with it as if I'm not diseased at all.…”

“…2,5,6,9,10 The few studies that did examine subjects' reasons for using self-management strategies reported explanations such as having a fixed daily routine and following the advice given by their doctor. 11 Reasons for not using self-management strategies included forgetfulness, belief that the medication was ineffective, not feeling any benefit, lack of perceived symptoms, denial that they have asthma, difficulty in using inhalers, inconvenience, fear of adverse effects, embarrassment, and laziness. [11][12][13][14] However, patients' reasons, perceptions, and behaviors in relation to using (or not using) self-management diaries remain largely unknown.…”

“…11 Reasons for not using self-management strategies included forgetfulness, belief that the medication was ineffective, not feeling any benefit, lack of perceived symptoms, denial that they have asthma, difficulty in using inhalers, inconvenience, fear of adverse effects, embarrassment, and laziness. [11][12][13][14] However, patients' reasons, perceptions, and behaviors in relation to using (or not using) self-management diaries remain largely unknown. Because existing studies 2,5,6,[9][10][11][12][13][14] are limited in scope and setting and focus merely on the subject, thus neglecting the role of the caregiver, the findings of these studies may not be transferable between patient types and settings.…”

“…[11][12][13][14] However, patients' reasons, perceptions, and behaviors in relation to using (or not using) self-management diaries remain largely unknown. Because existing studies 2,5,6,[9][10][11][12][13][14] are limited in scope and setting and focus merely on the subject, thus neglecting the role of the caregiver, the findings of these studies may not be transferable between patient types and settings. The aim of this qualitative study was to understand health-care professionals' and subjects' perceptions and behaviors related to selfmanagement diary use.…”