Asthma Patients Often Skip Their Medication
Study Shows Many Patients Aren't Always Honest With Their Doctors About Taking Medicine
By
Salynn Boyles
WebMD Health News
Reviewed By
Louise Chang, MD
Oct. 23, 2009 -- Many asthma patients with poorly controlled asthma do not
take their medications as prescribed, a new study from the U.K. suggests.
Researchers found that in about a third of cases, poor compliance with
treatment was a major factor in difficult-to-treat asthma.
"There are a lot of reasons patients don't take their medications as they
should," researcher Jacqueline Gamble of Queen's University of Belfast tells
WebMD. "Some of these treatments have side effects that are not pleasant,
especially oral corticosteroids. If patients aren't honest, or feel they can't
be honest with their doctors about this, there is very little way to know."
Worldwide, about 300 million people have asthma, including 23 million in the
U.S.
Every day in the U.S., 30,000 people have asthma attacks, 1,000 asthma
patients are admitted to hospitals, and 11 people die of the respiratory
disease, according to the Asthma and Allergy Foundation of America.
Poor treatment compliance has long been recognized as a significant issue in
the management of asthma, but the scope of the problem is not well understood
because objective measurement is difficult.
In the new study, Gamble and colleagues from Belfast City Hospital assessed
compliance with treatment in 182 consecutive patients attending a clinic
specializing in difficult-to-treat asthma.
Inhaled corticosteroid use was determined by examining initial and refill
prescriptions. Researchers used blood tests to assess oral steroid
compliance.
Among patients prescribed a maintenance course of oral steroid, the blood
analysis showed that nearly half (45%) were not taking their medication as
prescribed. And more than half of these patients (65%) were also noncompliant
with their inhaled treatment.
All of the poorly compliant patients had initially denied taking less of
their medications than they were prescribed.
Women were more likely than men to be poorly compliant, and patients who
scored lower on quality-of-life assessments were also less likely to take their
medications as directed.
Many Reasons for Poor Compliance
"Our experience suggests that not all patients have the same reasons for
poor adherence, and therefore a one-size-fits-all intervention is unlikely to
be appropriate," the researchers write in the November issue of the American
Journal of Respiratory and Critical Care Medicine.
American Thoracic Society past president John E. Heffner, MD, agrees there
are many reasons why people with asthma fail to take their medications as
prescribed.
"In cases where noncompliance is unintentional, poor communication is often
a big part of the problem," he tells WebMD. "Physicians may not communicate
instructions appropriately or give written instructions that can be easily
followed."
Patients may also intentionally fail to take their medications because they
are bothered by side effects or underestimate the seriousness of their
disease.
He says patients need to educate themselves about their asthma and doctors
need to understand that different patients may benefit from different
approaches to treatment.
Heffner, a professor of medicine at Providence Portland Medical Center,
says, "Physicians need to tailor therapy in a manner that meets the individual
medical, psychological, and social needs of the patient so that the patient has
the greatest opportunity to be compliant."
SOURCES: Gamble, J. American Journal of Respiratory and Critical Care Medicine, November 2009; vol 180: pp 817-822.
Jacqueline Gamble, PhD candidate, Center for Infection and Immunity, Queen's University of Belfast, Northern Ireland.
John E. Heffner, MD, Garniobst Chair, professor of medicine, Providence
Portland Medical Center, Portland, Ore.; past president, American Thoracic
Society.
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