| Autor: |
Chapman S; University of Bath, Bath, UK., Dale P; GSK, Brentford, UK.; Peter Dale, HEOR Solutions Ltd, Marlow, UK., Svedsater H; GSK, Brentford, UK., Stynes G; GSK, Brentford, UK.; Gillian Stynes, Bristol-Myers Squibb, Uxbridge, UK., Vyas N; Healthcare Research Worldwide, Wallingford Oxon, UK., Price D; Observational and Pragmatic Research Institute, Singapore, Singapore., Horne R; University College London, London, UK. r.horne@ucl.ac.uk. |
| Jazyk: |
angličtina |
| Zdroj: |
NPJ primary care respiratory medicine [NPJ Prim Care Respir Med] 2017 Nov 14; Vol. 27 (1), pp. 61. Date of Electronic Publication: 2017 Nov 14. |
| DOI: |
10.1038/s41533-017-0061-7 |
| Abstrakt: |
People with asthma who do not adhere to their maintenance medication may experience poorer asthma control and need more healthcare support than those who adhere. People (N = 1010) aged 18-55 years with self-reported asthma, taking one or more asthma maintenance medication(s), from five European countries, participated in a survey using validated scales (Medication Adherence Report Scale [MARS], Asthma Control Test™ [ACT], Beliefs about Medicine Questionnaire [BMQ] and the Asthma Treatment Intrusiveness Questionnaire [ATIQ]). We performed a post hoc evaluation of adherence to maintenance medication, asthma control, beliefs about medication, preferences for once-daily vs. twice-daily asthma maintenance medication and treatment intrusiveness, using structural equation modelling to investigate the relationships between these factors. Most participants reported potential problems with asthma control (ACT < 19: 76.8% [n = 776]), low adherence (median MARS = 3.40) and preferred once-daily medication (73.5% [n = 742/1010]). Non-adherence was associated with worse asthma control (r = 0.262 [P < 0.001]) and a expressed preference for once-daily medication over a "twice daily medication that works slightly better" (test statistic [T] = 2.970 [P = 0.003]). Participants reporting non-adherence/preferring once-daily medication had negative beliefs about their treatment (BMQ necessity-concerns differential: r = 0.437 [P < 0.001]/T = 6.886 [P < 0.001]) and found medication intrusive (ATIQ: r = -0.422 [P < 0.001]/T = 2.689[P = 0.007]). Structural equation modelling showed complex relationships between variables, including: (1) high concerns about treatment associated with increased perceived treatment intrusiveness and reduced adherence, which influenced asthma control; (2) high concerns about treatment and healthcare seeking behaviour, which were predictive of preferring twice-daily asthma medication. Concerns about medication and perceived treatment intrusiveness were predictive of poor adherence, and were associated with preference for once-daily asthma medication. Confirm the utility of the PAPA model and NCF in explaining nonadherence linked to poor asthma control. |
| Databáze: |
MEDLINE |
| Externí odkaz: |
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