Journal of Allergy and Clinical Immunology
Altering the Course of AsthmaOvercoming barriers to nonadherence in asthma treatment☆,☆☆
Section snippets
Nonadherence in children
Recent studies have demonstrated that poor adherence is a pervasive and endemic clinical problem in children. Adherence rates among 27 children with asthma were examined over a 6-month period in a study that used the Doser (MEDITRACK Products, Hudson, Mass) CT (Doser Clinical Trials version). This is a bottle cap device that attaches to the top of an inhaler and automatically monitors usage over a 45-day period.5 Objective data derived from the Doser CT were compared with other adherence
Treatment-related barriers to adherence
Patient nonadherence stems from a number of perceptions of and attitudes toward treatment.
Clinician-related barriers to adherence
Certain factors involving the physician or the setting of the physician's practice can encourage or discourage adherence.
Patient-related barriers to adherence
Attitudes and emotions the patient brings to the treatment formula may determine whether he or she will be adherent.
Strategies for promoting adherence
It is obviously not enough just to write a prescription, even for an effective and convenient medication. The patient's ability to adhere to a therapeutic regimen improves when clinicians address as many factors as possible.
Conclusions
Without substantial, long-term adherence, no medication, no matter how effective, can make the full therapeutic contribution needed to control a debilitating and increasingly prevalent chronic disease such as asthma. Treatments that are easier to take invite better adherence. Patients are better motivated to adhere to a therapy regimen when they understand their illness, have faith in their physicians and treatment, and are free of psychological disorders. Improving a patient's motivation is
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Dr Bender has been a member of the speakers bureau for Merck, Glaxo Wellcome, and Schering-Plough.
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Reprint requests: Bruce G. Bender, PhD, National Jewish Medical and Research Center, 1400 Jackson St, Denver, CO 80206.