Asthma patients' self-reported behaviours toward inhaled corticosteroids

Area of Science:

• Pulmonary Medicine
• Behavioral Science

Background:

• Patient adherence to inhaled corticosteroids (ICS) in asthma management is frequently suboptimal, characterized by irregular use or treatment interruptions.
• Understanding the factors contributing to the discontinuation of controller therapy is crucial for developing effective interventions.

Purpose of the Study:

• To investigate the characteristics and behaviors of asthma patients who interrupt their prescribed inhaled corticosteroids (ICS), whether intentionally or accidentally.
• To identify correlates of ICS interruptions to inform targeted patient support strategies.

Main Methods:

• A study included asthma patients prescribed ICS by general practitioners, utilizing self-report questionnaires and prescription data.
• Patient behaviors such as intentional/accidental ICS interruptions, reduced usage, and dose changes were assessed.
• Multiple Component Analysis (MCA) was employed to study interrelations between declared behaviors and identify correlates of ICS interruptions.

Main Results:

• 31.6% of patients intentionally interrupted ICS when feeling better, 25.4% forgot doses, and 18.3% deliberately altered doses.
• A significant correlation was found between intentional, accidental interruptions, and less frequent ICS use.
• Beliefs that constant respiratory therapy is unhealthy increased the risk of intentional interruption (OR=3.36), while ICS combination therapy decreased this risk (OR=0.24). Patients over 65 showed less frequent interruptions (OR=0.35).

Conclusions:

• Discontinuation of controller therapy in asthma is linked to other maladaptive behaviors and misconceptions regarding inhaled controllers.
• Future interventions should focus on modifying patients' perceptions and behaviors concerning controller therapy to enhance adherence.