Promoting Medication Adherence to Asthma

Abstract

Promoting adherence to asthma treatment is an essential aspect of clinical practice. Approximately 60% of asthmatic patients are non-adherent to asthma regimen, resulting in adverse outcomes and higher costs of care. Non-adherence could be intentional (perceptions of asthma severity, self-manage therapy, fear of side-effects) or non-intentional (forgetful, cost, and misunderstandings). Adherence can be evaluated by patient’s reporting, dose counter, electronic metered dose inhaler but using pharmacy records is a more cost-effective method. The most successful strategies to improve patients’ adherence is to utilize the principle of patient-centered collaborative care and effective communication. Keys of communication skills consist of establishing a relationship, listening, collaborating on the treatment plan, time management, and implementing effective follow-up interventions. Interventions to improve adherence include providing reinforcement for patients’ efforts to change, providing feedback on progress, tailoring education to patients’ needs and circumstances and follow-up. Evaluation of health literacy is mandatory for prioritizing information from most to least critical, speaking slowly, avoiding medical jargon, and spending minimal extra time during each visit. Communication technology including texting or interactive voice response is another new strategy that can increase adherence.