Inner-city minority adults with chronic asthma are more likely to take inhaled medicine if they believe in its benefits
Research Activities, March 2010, No. 355
Daily use of inhaled corticosteroids (ICS), even when patients have no asthma symptoms, is the cornerstone of managing persistent asthma. However, patients do not always adhere to such therapy. This is particularly true for minority patients living in inner cities, even when they have regular access to medical care and insurance. However, adult inner-city minorities with positive beliefs about ICS are more likely to adhere to the daily regimen, concludes a new study. Juan P. Wisnivesky, M.D., M.P.H., of Mount Sinai School of Medicine, and colleagues analyzed data on 261 patients with asthma from general internal medicine clinics in inner-city neighborhoods, who were prescribed daily ICS. Patients reported adherence to ICS using the Medication Adherence Reporting Scale at baseline and then again at 1 and 3 months. Patients were also asked questions related to the necessity of ICS therapy and concerns about side effects.
Seventy percent of patients reported using ICS all or most of the time when they had no asthma symptoms. The belief that it was important to use ICS, even when no symptoms were present, was the single most important predictor of adherence. Patients holding this conviction quadrupled their odds of being adherent to ICS. Adherence odds were also doubled in patients who were confident in their ability to properly use ICS. However, patients who were worried about ICS side effects or said they found the regimen hard to follow were about half as likely to adhere to the drug regimen.
Since high-risk, inner-city patients have the most problems and mortality from asthma, it is important to target these negative beliefs with educational messages. This, in turn, may improve adherence and patient outcomes, suggest the researchers. Their study was supported in part by the Agency for Healthcare Research and Quality (HS13312).
See "Impact of positive and negative beliefs about inhaled corticosteroids on adherence in inner-city asthmatic patients," by Diego Ponieman, M.D., Dr. Wisnivesky, Howard Leventhal, Ph.D., and others in the Annals of Allergy, Asthma & Immunology 103, pp. 38-42, 2009.