The Associations Between Neighborhood Factors on Asthma Medication Adherence in Adults

A significant portion of patients with asthma do not adhere to their medication regimen, and the influence of their neighborhood characteristics on their adherence is unclear.

To examine how certain neighborhood factors are associated with asthma medication adherence in adults.

Between 2020 and 2022, adults with asthma were recruited into the Global COVID-19 Asthma Study and completed an online questionnaire. A secondary post hoc analysis was performed. Perceived neighborhood and adherence responses were dichotomized, and a backward elimination change-in-estimate method was performed to choose variables for logistic regression analysis. A cumulative problem score was constructed from these perceptions, and a bivariate analysis was performed comparing adherent and nonadherent groups for each perception.

A total of 988 participants provided complete data, and almost half (44%) were medication nonadherent. Participants who reported a perceived problem with the presence of litter, homes not being well maintained, vacant homes, and vandalism in their neighborhood were more likely to be nonadherent, as well as those who felt unsafe walking alone at night and that their neighborhood was not a good place to live. Those who felt their neighborhood was not a good place to live were 1.79 times more likely to have reported nonadherence (95% confidence interval, 1.07-2.09) compared with those who did not have this feeling. Those with higher cumulative problem scores were also more likely to be nonadherent.

Neighborhood factors are associated with asthma medication adherence and provide valuable insights for providers when evaluating patient adherence.