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Erschienen in: Journal of General Internal Medicine 11/2014

01.11.2014 | Original Research

Strategies Used by Older Adults with Asthma for Adherence to Inhaled Corticosteroids

verfasst von: Taylor L. Brooks, Howard Leventhal, PhD, Michael S. Wolf, PhD, Rachel O’Conor, MPH, Jose Morillo, BA, Melissa Martynenko, MPA, MPH, Juan P. Wisnivesky, MD, DrPH, Alex D. Federman, MD, MPH

Erschienen in: Journal of General Internal Medicine | Ausgabe 11/2014

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ABSTRACT

BACKGROUND

Older adults with asthma have low levels of adherence to their prescribed inhaled corticosteroids (ICS). While prior research has identified demographic and cognitive factors associated with ICS adherence among elderly asthmatics, little is known about the strategies that older adults use to achieve daily use of their medications. Identifying such strategies could provide clinicians with useful advice for patients when counseling their patients about ICS adherence.

OBJECTIVE

To identify medication use strategies associated with good ICS adherence in older adults.

PARTICIPANTS

English-speaking and Spanish-speaking adults ages 60 years and older with moderate or severe asthma were recruited from primary care and pulmonary practices in New York City, NY, and Chicago, IL. Patients with chronic obstructive pulmonary disease, other chronic lung diseases or a smoking history of greater than 10 pack-years were excluded.

MAIN MEASURES

Medication adherence was assessed with the Medication Adherence Rating Scale (MARS). Medication use strategies were assessed via open-ended questioning. “Good adherence” was defined as a mean MARS score of 4.5 or greater.

KEY RESULTS

The rate of good adherence to ICS was 37 %. We identified six general categories of medication adherence strategies: keeping the medication in a usual location (44.2 %), integrating medication use with a daily routine (32.6 %), taking the medication at a specific time (21.7 %), taking the medication with other medications (13.4 %), using the medication only when needed (13.4 %), and using other reminders (11.9 %). The good adherence rate was greater among individuals who kept their ICS medication in the bathroom (adjusted odds ration [AOR] 3.05, 95 % CI 1.03–9.02, p = 0.04) or integrated its use into a daily routine (AOR 3.77, 95 % CI: 1.62–8.77, p = 0.002).

CONCLUSIONS

Keeping ICS medications in the bathroom and integrating them into daily routines are strategies associated with good ICS adherence. Clinicians concerned with adherence should consider recommending these strategies to their older asthmatic patients, although additional research is needed to determine whether such advice would improve adherence behaviors.
Literatur
1.
Zurück zum Zitat Bateman ED, Hurd SS, Barnes PJ, et al. Global strategy for asthma management and prevention: GINA executive summary. Eur Respir J. 2008;31(1):143–78.PubMedCrossRef Bateman ED, Hurd SS, Barnes PJ, et al. Global strategy for asthma management and prevention: GINA executive summary. Eur Respir J. 2008;31(1):143–78.PubMedCrossRef
2.
Zurück zum Zitat National Asthma Council Australia. Asthma Management Handbook, 2006. Available at http://www.nationalasthma.org.au/handbook. Accessed May 5, 2014. National Asthma Council Australia. Asthma Management Handbook, 2006. Available at http://​www.​nationalasthma.​org.​au/​handbook.​ Accessed May 5, 2014.
3.
Zurück zum Zitat Apter A, Boston R, George M, et al. Modifiable barriers to adherence to inhaled steroids among adults with asthma: It’s not just black and white. J Allergy Clin Immunol. 2003;111(6):1219–26.PubMedCrossRef Apter A, Boston R, George M, et al. Modifiable barriers to adherence to inhaled steroids among adults with asthma: It’s not just black and white. J Allergy Clin Immunol. 2003;111(6):1219–26.PubMedCrossRef
4.
Zurück zum Zitat van Eijken M, Tsang S, Wensing M, et al. Interventions to improve medication compliance in older patients living in the community: A systematic review of the literature. Drugs Aging. 2003;20(3):229–40.PubMedCrossRef van Eijken M, Tsang S, Wensing M, et al. Interventions to improve medication compliance in older patients living in the community: A systematic review of the literature. Drugs Aging. 2003;20(3):229–40.PubMedCrossRef
5.
Zurück zum Zitat Sofianou A, Martynenko M, Wolf MS, et al. Asthma beliefs are associated with medication adherence in older asthmatics. J Gen Intern Med. 2013;28(1):67–73.PubMedCrossRefPubMedCentral Sofianou A, Martynenko M, Wolf MS, et al. Asthma beliefs are associated with medication adherence in older asthmatics. J Gen Intern Med. 2013;28(1):67–73.PubMedCrossRefPubMedCentral
6.
Zurück zum Zitat Moorman JE, Rudd RA, Johnson CA, et al. National surveillance for asthma—United States, 1980–2004. MMWR Surveill Summ. 2007;56(8):1–54.PubMed Moorman JE, Rudd RA, Johnson CA, et al. National surveillance for asthma—United States, 1980–2004. MMWR Surveill Summ. 2007;56(8):1–54.PubMed
7.
Zurück zum Zitat Moorman JE, Zahran H, Truman BI, Molla MT. Current asthma prevalence—United States, 2006–2008. MMWR Surveill Summ. 2011;60(Suppl):84–86.PubMed Moorman JE, Zahran H, Truman BI, Molla MT. Current asthma prevalence—United States, 2006–2008. MMWR Surveill Summ. 2011;60(Suppl):84–86.PubMed
8.
Zurück zum Zitat Moorman JE, Mannino DM. Increasing U.S. asthma mortality rates: who is really dying? J Asthma. 2001;38(1):65–71.PubMedCrossRef Moorman JE, Mannino DM. Increasing U.S. asthma mortality rates: who is really dying? J Asthma. 2001;38(1):65–71.PubMedCrossRef
9.
Zurück zum Zitat Goeman D, Jenkins C, Crane M, Paul E, Douglass J. Educational intervention for older people with asthma: A randomised controlled trial. Patient Educ Couns. 2013;93(3):586–95.PubMedCrossRef Goeman D, Jenkins C, Crane M, Paul E, Douglass J. Educational intervention for older people with asthma: A randomised controlled trial. Patient Educ Couns. 2013;93(3):586–95.PubMedCrossRef
10.
Zurück zum Zitat Hartert TV, Togias A, Mellen BG, Mitchel EF, Snowden MS, Griffin MR. Underutilization of controller and rescue medications among older adults with asthma requiring hospital care. J Am Geriatr Soc. 2000;48(6):651–7.PubMed Hartert TV, Togias A, Mellen BG, Mitchel EF, Snowden MS, Griffin MR. Underutilization of controller and rescue medications among older adults with asthma requiring hospital care. J Am Geriatr Soc. 2000;48(6):651–7.PubMed
11.
Zurück zum Zitat Hartert TV, Windom HH, Peebles RS Jr, Freidhoff LR, Togias A. Inadequate outpatient medical therapy for patients with asthma admitted to two urban hospitals. Am J Med. 1996;100(4):386–94.PubMedCrossRef Hartert TV, Windom HH, Peebles RS Jr, Freidhoff LR, Togias A. Inadequate outpatient medical therapy for patients with asthma admitted to two urban hospitals. Am J Med. 1996;100(4):386–94.PubMedCrossRef
12.
Zurück zum Zitat Legorreta AP, Christian-Herman J, O’Connor RD, Hasan MM, Evans R, Leung KM. Compliance with national asthma management guidelines and specialty care: a health maintenance organization experience. Arch Intern Med. 1998;158(5):457–64.PubMedCrossRef Legorreta AP, Christian-Herman J, O’Connor RD, Hasan MM, Evans R, Leung KM. Compliance with national asthma management guidelines and specialty care: a health maintenance organization experience. Arch Intern Med. 1998;158(5):457–64.PubMedCrossRef
13.
Zurück zum Zitat Meng YY, Leung KM, Berkbigler D, Halbert RJ, Legorreta AP. Compliance with US asthma management guidelines and specialty care: a regional variation or national concern? J Eval Clin Pract. 1999;5(2):213–221.PubMedCrossRef Meng YY, Leung KM, Berkbigler D, Halbert RJ, Legorreta AP. Compliance with US asthma management guidelines and specialty care: a regional variation or national concern? J Eval Clin Pract. 1999;5(2):213–221.PubMedCrossRef
14.
Zurück zum Zitat Veehof L, Meyboom-de Jong B, Haaijer-Ruskamp FM. Polypharmacy in the elderly: a literature review. Informa Healthcare. 2000;6(3):98–106. Veehof L, Meyboom-de Jong B, Haaijer-Ruskamp FM. Polypharmacy in the elderly: a literature review. Informa Healthcare. 2000;6(3):98–106.
15.
Zurück zum Zitat Wagner GJ, Ryan GW. Relationship between routinization of daily behaviors and medication adherence in HIV-positive drug users. AIDS Patient Care and STDs. 2004;18(7):385–93.PubMedCrossRef Wagner GJ, Ryan GW. Relationship between routinization of daily behaviors and medication adherence in HIV-positive drug users. AIDS Patient Care and STDs. 2004;18(7):385–93.PubMedCrossRef
16.
Zurück zum Zitat Ryan GW, Wagner GJ. Pill taking ‘routinization’: a critical factor to understanding episodic medication adherence. AIDS Care. 2003;15(6):795–806.PubMedCrossRef Ryan GW, Wagner GJ. Pill taking ‘routinization’: a critical factor to understanding episodic medication adherence. AIDS Care. 2003;15(6):795–806.PubMedCrossRef
17.
Zurück zum Zitat Masood D, Cheriyan S, Patterson R. Management of Asthma in the geriatric population. Gerontology. 1996;42:183–9.PubMedCrossRef Masood D, Cheriyan S, Patterson R. Management of Asthma in the geriatric population. Gerontology. 1996;42:183–9.PubMedCrossRef
18.
Zurück zum Zitat Phillips AL, Leventhal H, Leventhal EA. Assessing theoretical predictors of long-term medication adherence: patients’ treatment-related beliefs, experiential feedback and habit development. Psychol Health. 2013;28(10):1135–51.CrossRef Phillips AL, Leventhal H, Leventhal EA. Assessing theoretical predictors of long-term medication adherence: patients’ treatment-related beliefs, experiential feedback and habit development. Psychol Health. 2013;28(10):1135–51.CrossRef
19.
Zurück zum Zitat Cohen JL, Mann DM, Wisnivesky JP, Horne R, Leventhal H, Musumeci-Szabó TJ, Halm EA. Assessing the validity of self-reported medication adherence among inner-city asthmatic adults: the medication adherence report scale for asthma. Annals of Allergy, Asthma & Immunology. 2009;103(4):325–31.CrossRef Cohen JL, Mann DM, Wisnivesky JP, Horne R, Leventhal H, Musumeci-Szabó TJ, Halm EA. Assessing the validity of self-reported medication adherence among inner-city asthmatic adults: the medication adherence report scale for asthma. Annals of Allergy, Asthma & Immunology. 2009;103(4):325–31.CrossRef
20.
Zurück zum Zitat Leventhal H, Leventhal EA, Breland JY. Cognitive science speaks to the “common-sense” of chronic illness management. Annals of Behavioral Medicine. 2011;41(2):152–63.PubMedCrossRef Leventhal H, Leventhal EA, Breland JY. Cognitive science speaks to the “common-sense” of chronic illness management. Annals of Behavioral Medicine. 2011;41(2):152–63.PubMedCrossRef
21.
Zurück zum Zitat Ponieman D, Wisnivesky JP, Leventhal H, Musumeci-Szabó TJ, Halm EA. Impact of positive and negative beliefs about inhaled corticosteroids on adherence in inner-city asthmatic patients. Annals of Allergy, Asthma & Immunology. 2009;103(1):38–42.CrossRef Ponieman D, Wisnivesky JP, Leventhal H, Musumeci-Szabó TJ, Halm EA. Impact of positive and negative beliefs about inhaled corticosteroids on adherence in inner-city asthmatic patients. Annals of Allergy, Asthma & Immunology. 2009;103(1):38–42.CrossRef
22.
Zurück zum Zitat Federman AD, Wolf M, Sofianou A, et al. The association of health literacy with illness and medication beliefs among older adults with asthma. Patient Educ Couns. 2013;92(2):273–8.PubMedCrossRefPubMedCentral Federman AD, Wolf M, Sofianou A, et al. The association of health literacy with illness and medication beliefs among older adults with asthma. Patient Educ Couns. 2013;92(2):273–8.PubMedCrossRefPubMedCentral
23.
Zurück zum Zitat Halm EA, Mora P, Leventhal H. No symptoms, no asthma: the acute episodic disease belief is associated with poor self-management among inner-city adults with persistent asthma. Chest. 2006;129(3):573–80.PubMedCrossRef Halm EA, Mora P, Leventhal H. No symptoms, no asthma: the acute episodic disease belief is associated with poor self-management among inner-city adults with persistent asthma. Chest. 2006;129(3):573–80.PubMedCrossRef
24.
Zurück zum Zitat Horne R, Weinman J, Hankins M. The beliefs about medicines questionnaire: the development and evaluation of a new method for assessing the cognitive representation of medication. Psychol Health. 1999;14:1–24.CrossRef Horne R, Weinman J, Hankins M. The beliefs about medicines questionnaire: the development and evaluation of a new method for assessing the cognitive representation of medication. Psychol Health. 1999;14:1–24.CrossRef
25.
Zurück zum Zitat Spitzer RL, Kroenke K, Williams JBW, Williams J, Lowe B, Lowe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006;166(10):1092–7.PubMedCrossRef Spitzer RL, Kroenke K, Williams JBW, Williams J, Lowe B, Lowe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006;166(10):1092–7.PubMedCrossRef
26.
27.
Zurück zum Zitat Federman AD, Wisnivesky JP, Wolf MS, Leventhal H, Halm EA. Inadequate health literacy is associated with suboptimal health beliefs in older asthmatics. J Asthma. 2010;47(6):620–626.PubMedCrossRef Federman AD, Wisnivesky JP, Wolf MS, Leventhal H, Halm EA. Inadequate health literacy is associated with suboptimal health beliefs in older asthmatics. J Asthma. 2010;47(6):620–626.PubMedCrossRef
28.
Zurück zum Zitat Baker DW, Williams MV, Parker RM, Gazmararian JA, Nurss J. Development of a brief test to measure functional health literacy. Patient Educ Couns. 1999;38(1):33–4.PubMedCrossRef Baker DW, Williams MV, Parker RM, Gazmararian JA, Nurss J. Development of a brief test to measure functional health literacy. Patient Educ Couns. 1999;38(1):33–4.PubMedCrossRef
Metadaten
Titel
Strategies Used by Older Adults with Asthma for Adherence to Inhaled Corticosteroids
verfasst von
Taylor L. Brooks
Howard Leventhal, PhD
Michael S. Wolf, PhD
Rachel O’Conor, MPH
Jose Morillo, BA
Melissa Martynenko, MPA, MPH
Juan P. Wisnivesky, MD, DrPH
Alex D. Federman, MD, MPH
Publikationsdatum
01.11.2014
Verlag
Springer US
Erschienen in
Journal of General Internal Medicine / Ausgabe 11/2014
Print ISSN: 0884-8734
Elektronische ISSN: 1525-1497
DOI
https://doi.org/10.1007/s11606-014-2940-8

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