Assessment of Adherence and Common Non-adherence Factors for Inhaled Medications in Asthma and Chronic Obstructive Pulmonary Disease (COPD) Patients

Abstract:

Background: Inhaled medications are the cornerstone for the treatment of asthma and chronic obstructive pulmonary disease (COPD). Adherence of inhaled medications can be influenced by many factors such as patient preferences, education and awareness. Therefore, it is fundamental to identify and address the factors that helps to improve adherence to inhaled medications. Hence, this study aims to assess the adherence and common non-adherence factors for inhaled medications in asthma and COPD patients. Materials and Methods: A prospective observational study was conducted at the department of respiratory medicine for 6 months in a tertiary care teaching hospital. A total of 150 patients who were diagnosed with asthma and COPD, and used inhaled medications were enrolled. Patients were interviewed and administered with Inhaled Medication Adherence Questionnaire (IMAQ). The identified factors for non-adherence were classified based on the five dimensions of adherence instrumented by the World Health Organization (WHO). Results: A total of 97/150 (64.7%) patients [asthma: 42 (64.2%) and COPD: 55 (68.7%)] were found non-adherent to inhaled medications. Between them, 54% were attributable to socioeconomic reasons, 38% were patient-related, 4.6% therapy-related and 3.3% healthcare system-related. According to the study results majority of patients showed non-adherence due to socioeconomic-related factors followed by patient-related factors. Conclusion: This study concluded that non-adherence to inhaled medication was high in asthma and COPD patients. Low economic status, social stigma, lack of knowledge, inappropriate usage technique and complexity of treatment were the most common factors influencing non-adherence to inhaled medications in asthma and COPD.

Keywords: Asthma, Chronic obstructive pulmonary disease (COPD), Medication adherence, Medication adherence questionnaire, Non-adherence factors.