Factors Influencing Adherence to Inhaled Corticosteroids in Patients with Asthma
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Abstract
A cross-sectional study design aimed to examine the influence of age, gender, inhaler technique, knowledge of drug use, smoking, depression, and asthma control on inhaled corticosteroid adherence in patients with asthma. The sample consisted of 164 asthmatic participants, diagnosed by lung function test, aged 18 years or above, both males and females, with normal cognitive function (GP-COG score of 9 for patients aged 60 years or over), ability to communicate in Thai, no other lung diseases, no psychiatric disorders, and no comorbidity with severe symptoms. Data were collected at the Asthma Clinic, a super-tertiary hospital in Bangkok. The research instruments comprised a personal information questionnaire and health record, an inhaled medication adherence questionnaire, an inhaler technique assessment, an inhaled corticosteroid knowledge questionnaire, the Center for Epidemiologic Studies Depression Scale (CES-D), and an asthma control assessment form based on the Global Initiative for Asthma (GINA) criteria. The reliability of the questionnaires was assessed by Cronbach's alpha coefficient, equal to 0.89 for the inhaled medication adherence questionnaire, 0.73 for the inhaled corticosteroid knowledge questionnaire, 0.78 for the CES-D, and 0.74 for the asthma control assessment as determined by the Kuder-Richardson. Descriptive statistics and the logistic regression enter method were used to analyze the data.
The results showed that 69.51% of participants were female, with an average age of 63.82 (SD = 12.82); 61.7% adhered to inhaled corticosteroids. Age, gender, inhaler technique, knowledge of inhaled corticosteroids, smoking, depression, and disease control were not correlated and could not predict adherence to inhaled corticosteroids. Only depression and asthma control could predict adherence to inhaled corticosteroids (OR = 2.30, 95% CI: 1.02 - 5.18, p = .04; and OR = 3.00, 95% CI: 1.44 - 6.21, p = .01, respectively). Depression management and support for patients to control asthma will help patients adhere to inhaled corticosteroids, so nurses should assess patients' depression and provide information on the risk factors, and management that can lead to increased adherence to inhaled corticosteroids.
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