Patient Empowerment Can Increase Asthma Medication Adherence, Finds Review

Empowering patients with asthma to make informed decisions surrounding medication adherence instead of “adherence controlling” by health professionals, as well as effective dialogue and appropriate education, are vital to increase medication adherence, found a qualitative systematic review published in Journal of Asthma and Allergy.

This study was conducted because many studies have found that patient adherence to maintenance medication for asthma is poor, even though it is known that increased medication adherence contributes to better asthma control and health outcomes.

The researchers conducted a meta-synthesis of qualitative studies to analyze patients’ with asthma and health care professionals’ medication adherence perspectives.

“Increased medication adherence leads to better asthma control and health outcomes, decreases the risk of future asthma exacerbations and healthcare costs. Therefore, understanding patient perceptions and behaviours and the possible barriers to assess this adherence issue is very important,” said the researchers.

A total of 12 articles reporting findings from 433 total participants, including 315 patients and 118 health care professionals, were included in the review.

There were 4 synthesized findings with subthemes that were identified from the reviewed studies and were described as:

• The role of relationship and communication with and between health care providers in medication adherence
• Insufficient information from providers creating an adherence barrier
• How patient attitudes and beliefs affect their medication adherence
• The role of patients’ personal behavior and other barriers

Previous studies have suggested that the perception of lower medication necessity and lack of faith in the treatment was linked with nonadherence, along with limited health literacy and family and culture. Therefore, researchers said it’s important to consider the individual health literacy and cultural perspective of patients when creating an education program or self-management strategies so that they can be individualized.

The researchers also suggested considering the addition of friends or family members into the patient’s treatment plan.

Additionally, they recommended using technology to improve communication between health care professionals and patients, such as through an electronic device to track adherence, remind patients to take medication, receive feedback on inhaler technique, avoid triggers, or book an appointment. Timely follow ups were also endorsed.

Following the findings, researchers recommended that providers ensure that patients’ decisions are based on quality information, and that effective communication between health professionals and patients will grow patients’ trust, motivation, and drive better adherence and health outcomes.

“Finally, educational interventions to improve patients’ knowledge of their disease and treatment adherence is needed based on individual understanding to truly empower patients to make informed decisions on their treatment rather than decisions just being made by healthcare professionals,” they emphasized.

The study did have some limitations. In the reviewed studies, only 1 included a minority ethnic group, so it is worth exploring further how cultural beliefs and perceptions of minority ethnic groups affect behavior and medication adherence. Furthermore, the included studies were only in English and grey literature was not included, which could be a limitation.

Reference

Zhang X, Ding R, Zhang Z, Chen M, Yin Y, Quint JK. Medication adherence in people with asthma: a qualitative systematic review of patient and health professional perspectives. J Asthma Allergy. 2023;16:515-527
https://doi.org/10.2147/JAA.S407552