Abstract
Background: Non-adherence to inhalation regimens is common in asthma. The ASK-12 survey was developed to detect and address patient-specific barriers to medication adherence.
Objective: To investigate the clinical usefulness of the ASK-12 for assessing and addressing adherence to inhalation therapy in asthma.
Methods: The ASK-12 was administered to 138 asthmatic patients. Using pharmacy-refill data, we examined the cut-off value of the ASK-12 to identify patients who were non-adherent to inhalation regimens and identify factors associated with non-adherence. To verify the usefulness of the ASK-12, inhalation regimens were prospectively switched to less-expensive and simpler dosing regimens in 8 non-adherent patients who reported specific-barriers in “inconvenience of twice-daily inhaler use” and “cost.”
Results: Valid responses were received from 114 patients. A significant correlation was found between pharmacy-refill rates and the ASK-12 total score(r=-0.55, p<0.0001).The optimal cut-off value of the ASK-12 total score to identify non-adherent patients defined by pharmacy-refill rate<80% was 23, with 71.4% specificity and 93.3% sensitivity. Using this value, 52 (45.6%) patients were classified as non-adherent. Univariate followed by multivariate analysis identified younger age as a predictor of non-adherence to inhalation regimens [Exp (β), 1.06; 95% CI 0.022 to 0.100; p=0.003]. Switching inhaled medicines in 8 patients resulted in significant improvements in both ASK-12 scores and asthma control.
Conclusions: The ASK-12 is a brief, practical, and useful measure for assessing and addressing adherence to inhalation regimens in asthma.
- Copyright ©the authors 2016
