Topic :The Patient's Perspective: Adherence or Non - adherence to Asthma Controller Therapy?ASAPSummaries all this into bullet points to more simply:In the clinical management of asthma, the most important hurdle to overcome is most likely the cooperation of the patient regarding medication (9), and the present cross-sectional study of a relatively large population of adult asthmatics revealed, As expected, that both accidental and intentional non-adherence with inhaled corticosteroid therapy is very common in adults. At the level of the individuapatienttl-known traits, as well as some newer, hitherto less recognized characteristics, were identified. Most of the factors associated with non-adherence reflected the patients' lack of understanding-or acceptance of having a chronic disease requiring maintenance therapy. Most likely, these reasons reflect suboptimal patient-caregiver communication. It should, therefore, be possible to achieve a substantial im- improvement in adherence through education of both patients and caregivers. Self-perceived severe asthma was significantly associated with better adherence with ICS therapy, whereas only a tendency was found for an association between adherence and symptom severity assessed based on ones (4). These observations might indicate that the most important factor leading to goodness is the patient's perception of disease severity. The clinical implication of this may be, not least for patients with more severe asthma, that if we as caregivers can convey our judgment abaaboutsubstantially reduce the risk for non-adherence. This assumption is further supported by the finding that patients who perceived their asthma as being severe were more likely to remember their controller therapy due to a fixed routine compared with patients who perceived their asthma as being mild. Identifying reasons for non-adherence with asthma therapy has been the objective in most studies about clinical asthma management (10-12), and much less emphasis has been given to factors promoting good adherence to treatment (7). This survey revealed that 73% of the asthmatics complied with their treatment regimes losing only one or two doses of controller medication a month, or even less, i.e., they showed good adherence to therapy. More than half of the compliant patients were so because they had succeeded in making medication a firm daily habit, and a quarter of the patients complied with treatment simply bbecause itttthad been recommended by their doctor. The clinical implications of these findings are likely to be ttruttruant, pieces of advice to patients - given by their caregivers could promote further adherence to therapy. In this study, we focused on both accidental and intentional non - adherence. The most important difference between these two types of non-adherence is that patients in the former category are unaware that they are not complying, whereas intentional non-adherence requires a conscious decision by the patient to reject the treatment (and sometimes also the diagnosis) (6, 9). The two kinds of non - adherence often coexist in the same individual. Improving adherence for patients with both types of non - adherence will require the education of both patients and caregivers. However, it would be expected that patients with predominantly intentional non-adherence would be the most difficult group to reach, but, fortunately, the present study revealed that intentional non-adherence in most cases is due to the absence of perceived asthma symptoms, and less than 10 % of the patients mentioned factors implicating a deeper psychological background for non - adherence. This makes it reasonable to believe that education and improved patient-caregiver communication can reduce the proportion of patients with clinically important non-compliance This cross-sectional questionnaire study revealbut but the assessment of asthma severity In the individual patient remains a problem in everyday clinical practice, not least when it comes to the identification of the patients who according to the current guidelines should receive controller therapy. In the present study, the GINA classificatibasibasis off of selbasisooffereddd symptoms (4). However, in individuals already on controller therapy, the GINA 2002 severity classification is based on both prescribed drug regimens, level of lung function, and symptom severity (14). The symptom severity classification used in this study is therefore likely to have underestimated the true level of asthma which is in keeping with observations recently reported by Fuhlbrigge et al . (15 ) from a cross-sectional telephone survey comprising almost 2,000 adults with asthma As the design of the study tended to exclude patients with milder asthma the observed gap in percentage between the patients is d ICS treatment and those who should have been on ICS is unlikely to have been exaggerated in the present study in some countries, the use of an Internet-based squestionnaireirenaireireireirey result in a highly selected sample of patients However in Denmark 90% of the population have access to the Internet either from their home or at work, and in a minor proportion from Internet cafes and libraries (16). This study ULRIK ET AL, therefore,e, further supports the assumption that research can be successfully performed using the Internet In conclusion, this questionnaire study of adult asthmpapatientsonstratedddthat non-adherence with controller therapy as dissected, ll a major problem in clinical asthma management. The reasons for non-adherence, well as for good adherence, were often simple and should be possible to influence in a positive direction by a targeted educational effort.

Question

Topic :The Patient's Perspective: Adherence or Non - adherence to Asthma Controller Therapy?ASAPSummaries all this into bullet points to more simply:In the clinical management of asthma, the most important hurdle to overcome is most likely the cooperation of the patient regarding medication (9), and the present cross-sectional study of a relatively large population of adult asthmatics revealed,  As expected, that both accidental and intentional non-adherence with inhaled corticosteroid therapy is very common in adults.  At the level of the individuapatienttl-known traits, as well as some newer, hitherto less recognized characteristics, were identified.  Most of the factors associated with non-adherence reflected the patients' lack of understanding-or acceptance of having a chronic disease requiring maintenance therapy.  Most likely, these reasons reflect suboptimal patient-caregiver communication.  It should, therefore, be possible to achieve a substantial im- improvement in adherence through education of both patients and caregivers.  Self-perceived severe asthma was significantly associated with better adherence with ICS therapy, whereas only a tendency was found for an association between adherence and symptom severity assessed based on ones (4).  These observations might indicate that the most important factor leading to goodness is the patient's perception of disease severity.  The clinical implication of this may be, not least for patients with more severe asthma, that if we as caregivers can convey our judgment abaaboutsubstantially reduce the risk for non-adherence.  This assumption is further supported by the finding that patients who perceived their asthma as being severe were more likely to remember their controller therapy due to a fixed routine compared with patients who perceived their asthma as being mild.  Identifying reasons for non-adherence with asthma therapy has been the objective in most studies about clinical asthma management (10-12), and much less emphasis has been given to factors promoting good adherence to treatment (7).  This survey revealed that 73% of the asthmatics complied with their treatment regimes losing only one or two doses of controller medication a month, or even less, i.e., they showed good adherence to therapy.  More than half of the compliant patients were so because they had succeeded in making medication a firm daily habit, and a quarter of the patients complied with treatment simply bbecause itttthad been recommended by their doctor.  The clinical implications of these findings are likely to be ttruttruant, pieces of advice to patients - given by their caregivers could promote further adherence to therapy.  In this study, we focused on both accidental and intentional non - adherence.  The most important difference between these two types of non-adherence is that patients in the former category are unaware that they are not complying, whereas intentional non-adherence requires a conscious decision by the patient to reject the treatment (and sometimes also the diagnosis)  (6, 9).  The two kinds of non - adherence often coexist in the same individual.  Improving adherence for patients with both types of non - adherence will require the education of both patients and caregivers.  However, it would be expected that patients with predominantly intentional non-adherence would be the most difficult group to reach, but, fortunately, the present study revealed that intentional non-adherence in most cases is due to the absence of perceived asthma symptoms, and less than 10 % of the patients mentioned factors implicating a deeper psychological background for non - adherence.  This makes it reasonable to believe that education and improved patient-caregiver communication can reduce the proportion of patients with clinically important non-compliance This cross-sectional questionnaire study revealbut but the assessment of asthma severity  In the individual patient remains a problem in everyday clinical practice, not least when it comes to the identification of the patients who according to the current guidelines should receive controller therapy.  In the present study, the GINA classificatibasibasis off of selbasisooffereddd symptoms (4).  However, in individuals already on controller therapy, the GINA 2002 severity classification is based on both prescribed drug regimens, level of lung function, and symptom severity (14).  The symptom severity classification used in this study is therefore likely to have underestimated the true level of asthma which is in keeping with observations recently reported by Fuhlbrigge et al .  (15 ) from a cross-sectional telephone survey comprising almost 2,000 adults with asthma  As the design of the study tended to exclude patients with milder asthma the observed gap in percentage between the patients is d ICS treatment and those who should have been on ICS is unlikely to have been exaggerated in the present study in some countries, the use of an Internet-based squestionnaireirenaireireireirey result in a highly selected sample of patients However in Denmark  90% of the population have access to the Internet either from their home or at work, and in a minor proportion from Internet cafes and libraries (16).  This study ULRIK ET AL, therefore,e, further supports the assumption that research can be successfully performed using the Internet  In conclusion, this questionnaire study of adult asthmpapatientsonstratedddthat non-adherence with controller therapy as dissected, ll a major problem in clinical asthma management.  The reasons for non-adherence, well as for good adherence, were often simple and should be possible to influence in a positive direction by a targeted educational effort.

Accepted Answer

Asthma is one of the major diseases that are non-communicable that can affect both adults and…

Adherence or Non - adherence to Asthma Controller Therapy? ASAP Summaries all this into bullet points