Influence factors of treatment compliance in adult asthma patients in Shanghai

Abstract

Objective \nTo investigate the treatment compliance and influencing factors of adult asthma patients in Shanghai. \n \n \nMethods \nA multi-center cross-sectional study was conducted to investigate adult asthma patients who were reexamined in outpatient clinics of 9 hospitals in Shanghai.Questionnaires included the basic information of patients, disease awareness, Morisky medication adherence questionnaire, the use of asthma drugs, and the reasons for non-compliance.According to Morisky score, 499 asthmatic patients treated with inhaled glucocorticoids were divided into two groups: the poor compliance group (Morisky score <6) and the better compliance group (Morisky score <6). The two groups were compared. \n \n \nResults \nThere were 259 cases (51.9%) in poor compliance group and 240 cases (48.1%) in better compliance group.Compared with the better compliance group, the poor compliance group had a higher proportion of patients in the 18-30 age group and specialized clinic (χ2=6.331, 8.983, both P<0.05), while the proportion of patients in the 50-70 age group and expert clinic was lower (χ2=8.088, 4.711, both P<0.05). The correction rate of the first to fifth items of asthma knowledge in poor compliance group was significantly lower than that in the group with better compliance (χ2=19.860, 4.711, 5.345, 27.677, 24.975, all P<0.05). And the proportion of patients who knew less than (or equal to) 2 items increased significantly in poor compliance group (χ2=20.980, P<0.01). Compared with the group with better compliance, the proportion of inhaled short-acting bronchodilator, oral compound methoxyphenamine and traditional Chinese medicine treatment use were higher in the group with poor compliance (χ2=6.449, 5.208, 5.933, all P<0.05). The proportion of patients use more than 4 kinds of medications for treating asthma in poor compliance group was significantly higher than in better compliance group (χ2=20.980, P<0.01). The proportion of patients in poor compliance group who did not comply with doctor′s advice because of conscious improvement, forgetting medication, unwilling to use inhalation for a long time, fear of drug dependence, difficulty in long-term persistence and troublesome device use was significantly higher than that in better compliance group (χ2=59.842, 45.303, 20.607, 18.163, 33.659, 9.26, all P<0.01), and the proportion of patients who did not comply with doctor′s advice due to poor drug efficacy was also higher (χ2=4.452, P<0.05). \n \n \nConclusions \nAsthma treatment compliance in Shanghai is less than 50%.The main causes include insufficient awareness of long-term treatment of asthma, Conscious improvement of the condition, forgetting to use drugs, and reluctance to use inhalation for a long time.Corresponding measures should be taken to improve treatment compliance and achieve good control of asthma. \n \n \nKey words: \nAsthma;\xa0Medication adherence;\xa0Influence factor