LOW ADHERENCE TO TREATMENT – A PROBLEM OF MANAGEMENT AND CONTROL OF BRONCHIAL ASTHMA
Keywords:
importance, readiness and adherence to drug therapy, importance, readiness and adherence to medical support, importance, readiness and adherence to lifestyle modification, indicator of integral adherence to treatmentAbstract
In order to study the adherence to treatment of patients with bronchial asthma (BA), a questionnaire for the quantitative assessment of adherence to treatment (COP 25) was used, which made it possible to evaluate the indicators of "importance" and "readiness" for the components of "drug therapy", "medical support" and "lifestyle modification", which in patients with BA turned out to be low, ranging from 42% to 68% of the maximum possible level.
According to the results of our own study, the level of adherence to drug therapy in 100% of BA patients is low, amounting to only 20.9%, which means that patients will not or most likely will not follow medical recommendations and actions based on them. The level of adherence to medical support in 24% of patients with asthma had an average level (above 50%, but less than 75%), which determined that medical recommendations and actions based on them would be carried out by patients more likely than not, and 76% of patients had a low level commitment to medical support. The level of adherence to lifestyle modification in 4% of patients had an average level and in 96% - a low level. The indicator of integral adherence to treatment in 100% of patients had a low adherence level of less than 50%, amounting to only 29%, characterizing that medical recommendations and actions based on them will not be followed by patients or most likely will not be.
Comparative characteristics of the factors that determine the low level of adherence of asthma patients to medical treatment programs, medical support and lifestyle modification do not provide statistically significant differences in study cohort groups with non-modifiable barriers, including gender, age, education, social status, disease duration and severity obstructive disorders.
Increasing adherence to treatment provides a higher patient-oriented efficiency in the provision of medical care to patients, which will contribute to improving the quality and life expectancy of patients and to a large extent determine the outcome of therapy and control of a chronic disease.
References
Визель А.А., Визель И.Ю., Салахова И.Н., Вафина А.Р. Приверженность при бронхиальной астме и хронической обструктивной болезни легких: от проблемы к решению//Фарматека. -2019.-26(5).-с.122–126.
Лукина Ю.В., Кутишенко Н.П., Марцевич С.Ю. Приверженность лечению: современный взгляд на знакомую проблему// Кардиоваскулярная терапия и профилактика. - 2017. -16(1). -с.91-95.
Ненашева Н.М. Приверженность к лечению больных бронхиальной астмой и возможные стратегии ее повышения // Практическая пульмонология. -2014. -№ 4. -с. 2–9.
Николаев Н.А., Скирденко Ю.П. Российский универсальный опросник количественной оценки приверженности к лечению (КОП 25)// Клиническая фармакология и терапия. - 2018. -Т. 27. - №1. -с.74-78.
Binhas E. Comment augmenter l`acceptation des plans de traitement //Dialgue, 1999; 13-15
Chowdhury R, Khan H, Heydon E, et al. Adherence to cardiovascular therapy: a metaanalysis of prevalence and clinical consequences // Eur Heart J., 2013;34:2940-2948.
Cowell W., Fulford-Smith A., Poultney S. Adherence with bisphosphonate treatment for osteoporosis in UK patients. Poster presented the second joint meeting of the European Calcified Tissue Society and the International Bone Mineral Society. Geneva, 25—29 June 2005
George M. Adherence in Asthma and COPD: New strategies for an old problem// Respir Care. 2018;63(6):818–831.
Global Initiative for Asthma. GINA 2019. (Electronic resource). URL: https://ginasthma.org/wp-content/uploads/2019/06/GINA-2019-main-report-June-2019-wms.pdf. Access date: 19.04.2020
Lahdenpera T.S., Wright C.C., Kyngas H.A. Development of a scale to assess the compliance of hypertensive patients// Int J Nurs Stud., 2003 Sep; 40 (7): 677—684.
McQuaid E.L. Barriers to medication adherence in asthma. The importance of culture and context // Ann. Allergy Asthma Immunol., 2018; 121(1): 37–42.
Mishra R., Kashif M., Venkatram S., George T., Luo K., Diaz-Fuentes G. Role of Adult Asthma Education in Improving Asthma Control and Reducing Emergency Room Utilization and Hospital Admissions in an Inner City Hospital//Can Respir J., 2017;5681962. doi: 10.1155/2017/5681962
Normansell R., Kew K.M., Stovold E. Interventions to improve adherence to inhaled steroids for asthma //Cochrane Database Syst Rev., 2017;18(4):CD012226.
Urek M.C., Tudorić N., Plavec D., Urek R., Koprivc-Milenović T., Stojić M. Effect of Educational Programs on Asthma Control and Quality of Life in Adult Asthma Patients// Patient Educ Couns., 2005;58(1):47–54.
World Health Organization. Adherence to long-term therapies: evidence for action. WHO Library Cataloguing-in-Publication Data, Geneva, WHO, 2003.
Wu A.C., Butler M.G., Li L., et al. Primary adherence to controller medications for asthma is poor //Ann Am Thorac Soc., 2015;12(2):161–166.
