Asthma Control in Adolescents: the Importance of Assessing Adherence

Overview

Journal Acta Biomed

Specialty General Medicine

Date 2022 Aug 31

PMID 36043978

Authors

Giorgio Ciprandi

Amelia Licari

Riccardo Castagnoli

Riccardo Ciprandi

Gian Luigi Marseglia

Affiliations

Soon will be listed here.

Abstract

Background Asthma control is the goal of the management, but some patients do not achieve adequate control. Adherence to prescriptions is a relevant factor in this issue. As very few studies addressed this problem in adolescents, we investigated this aspect in this setting. Methods This cross-sectional study consecutively enrolled 87 adolescents (60 males, 27 females, median age 14.2 years) with asthma visited at a third-level pediatric clinic. We used two questionnaires: Morisky Medication Adherence Scale (MMAS-8) and TAI. Results As regards MMAS-8, 23 (26.6%) adolescents had low adherence, 34 (39%) medium, and 30 (34.4%) high. Concerning TAI, 34 (39%) had low adherence, 43 (49.5%) medium, and 10 (11.5%) high. After stratification per asthma control grade, adolescents with partly-controlled asthma had the highest scores for medium adherence (p=0.0017 and 0.049, respectively for MMAS-8 and TAI). Conclusions Adolescents with asthma have poor adherence independently to the asthma control grade. This failure implicates that more attention should be paid to this issue in clinical practice.

Citing Articles

Current Approaches in the Multimodal Management of Asthma in Adolescents-From Pharmacology to Personalized Therapy.

Lupu V, Jechel E, Fotea S, Morariu I, Starcea I, Azoicai A Biomedicines. 2023; 11(9).

PMID: 37760870 PMC: 10525469. DOI: 10.3390/biomedicines11092429.

References

Pearce C, Fleming L . Adherence to medication in children and adolescents with asthma: methods for monitoring and intervention. Expert Rev Clin Immunol. 2018; 14(12):1055-1063. DOI: 10.1080/1744666X.2018.1532290. View

De Simoni A, Fleming L, Holliday L, Horne R, Priebe S, Bush A . Electronic reminders and rewards to improve adherence to inhaled asthma treatment in adolescents: a non-randomised feasibility study in tertiary care. BMJ Open. 2021; 11(10):e053268. PMC: 8559117. DOI: 10.1136/bmjopen-2021-053268. View

De Simoni A, Horne R, Fleming L, Bush A, Griffiths C . What do adolescents with asthma really think about adherence to inhalers? Insights from a qualitative analysis of a UK online forum. BMJ Open. 2017; 7(6):e015245. PMC: 5734261. DOI: 10.1136/bmjopen-2016-015245. View

Plaza V, Fernandez-Rodriguez C, Melero C, Cosio B, Entrenas L, Perez de Llano L . Validation of the 'Test of the Adherence to Inhalers' (TAI) for Asthma and COPD Patients. J Aerosol Med Pulm Drug Deliv. 2015; 29(2):142-52. PMC: 4841905. DOI: 10.1089/jamp.2015.1212. View

Robinson P, Jayasuriya G, Haggie S, Uluer A, Gaffin J, Fleming L . Issues affecting young people with asthma through the transition period to adult care. Paediatr Respir Rev. 2021; 41:30-39. DOI: 10.1016/j.prrv.2021.09.005. View

Asamoah-Boaheng M, Bonsu K, Farrell J, Oyet A, Midodzi W . Measuring Medication Adherence in a Population-Based Asthma Administrative Pharmacy Database: A Systematic Review and Meta-Analysis. Clin Epidemiol. 2021; 13:981-1010. PMC: 8547830. DOI: 10.2147/CLEP.S333534. View

Morisky D, Ang A, Krousel-Wood M, Ward H . Predictive validity of a medication adherence measure in an outpatient setting. J Clin Hypertens (Greenwich). 2008; 10(5):348-54. PMC: 2562622. DOI: 10.1111/j.1751-7176.2008.07572.x. View

Rehman N, Morais-Almeida M, Wu A . Asthma Across Childhood: Improving Adherence to Asthma Management from Early Childhood to Adolescence. J Allergy Clin Immunol Pract. 2020; 8(6):1802-1807.e1. PMC: 7275896. DOI: 10.1016/j.jaip.2020.02.011. View

Vazquez-Ortiz M, Angier E, Blumchen K, Comberiati P, Duca B, DunnGalvin A . Understanding the challenges faced by adolescents and young adults with allergic conditions: A systematic review. Allergy. 2020; 75(8):1850-1880. DOI: 10.1111/all.14258. View

10.

Duarte-de-Araujo A, Teixeira P, Hespanhol V, Correia-de-Sousa J . COPD: understanding patients' adherence to inhaled medications. Int J Chron Obstruct Pulmon Dis. 2018; 13:2767-2773. PMC: 6132238. DOI: 10.2147/COPD.S160982. View

11.

Tosca M, Marseglia G, Ciprandi G . The real-world "ControL'Asma" study: a nationwide taskforce on asthma control in children and adolescents. Allergol Immunopathol (Madr). 2021; 49(1):32-39. DOI: 10.15586/aei.v49i1.14. View

12.

Plaza V, Giner J, Curto E, Alonso-Ortiz M, Orue M, Vega J . Assessing Adherence by Combining the Test of Adherence to Inhalers With Pharmacy Refill Records. J Investig Allergol Clin Immunol. 2019; 31(1):58-64. DOI: 10.18176/jiaci.0461. View

13.

Hauerslev M, Garpvall K, Marckmann M, Hermansen M, Hansen K, Chawes B . Long-term predictors of loss of asthma control in school-aged well-controlled children with mild to moderate asthma: A 5-year follow-up. Pediatr Pulmonol. 2021; 57(1):81-89. DOI: 10.1002/ppul.25710. View

14.

Roberts G, Vazquez-Ortiz M, Knibb R, Khaleva E, Alviani C, Angier E . EAACI Guidelines on the effective transition of adolescents and young adults with allergy and asthma. Allergy. 2020; 75(11):2734-2752. DOI: 10.1111/all.14459. View

15.

Kaplan A, Price D . Treatment Adherence in Adolescents with Asthma. J Asthma Allergy. 2020; 13:39-49. PMC: 6969681. DOI: 10.2147/JAA.S233268. View

16.

Takkinsatian Md P, Chantaratin Md S, Sirisakpanit MSc Clinical Psychology S, Srisuwatchari Md W, Pacharn Md P, Jirapongsananuruk Md O . Psychosocial factors and lack of asthma knowledge undermine child and adolescent adherence to inhaled corticosteroid. J Asthma. 2021; 59(11):2234-2245. DOI: 10.1080/02770903.2021.1999468. View