Therapeutic compliance among asthma patients in an allergy clinic: third evaluation (SEGARIA Project)

To perform a third evaluation of therapeutic compliance in asthma patients managed in our department by using identical methodology to that employed in two prior evaluations (1995 and 1993). To study the possible association between correct inhalation technique and the patient's degree of knowledge about asthma.

A random sample with a fixed rate was obtained, comprising 54 adult patients with asthma (aged more than 18 years old) managed in our department in an outpatient regime. Patients who reported that they habitually failed to comply with the treatment duration, the number of dosage times per day, or the dose at each specific dosage time were classified as noncompliers with the medication in question. The study was performed during October and November, 2003. First visits were excluded. The same categories of medications and procedures as those employed in the 1993 and 1995 studies were used.

Of the 54 patients studied, 19% revealed some type of pharmacological noncompliance. The overall percentage of incorrectly used medication was 8%. Among noncompliers, clinical course was poor in 44% and additional visits to specialists or the emergency room were required in 45%. Incorrect use was most frequent with the turbuhaler (32.1%), and faulty technique was also most common with this device (67.9%).

In this evaluation, overall therapeutic compliance was clearly better than that in 1995 (81% compared with 54%), indicating a positive tendency over time. These results were more positive than those reported in the scientific literature on therapeutic compliance. Nevertheless, correct inhalation technique was markedly less frequent than in our previous studies. The most incorrectly used pharmacological groups continue to be the controller medications. A nonsignificant tendency among noncompliers to require more additional visits and to have worse clinical course and less knowledge about their disease than compliers was maintained. This type of evaluation continues to be useful in the clinical monitoring of therapeutic complicance in daily clinical practice.