Faculty of Public Health and Social Welfare, Riga Stradins University, Dzirciema 16, Riga, LV-1007, Latvia.
Faculty of Medicine, Riga Stradins University, Dzirciema 16, Riga, LV-1007, Latvia.
NPJ Prim Care Respir Med. 2017 Jun 20;27(1):39. doi: 10.1038/s41533-017-0042-x.
One of the main challenges in asthma control is adherence to pharmaceutical treatment. The aim of this study was to test the association between adherence to asthma medication, control and medical beliefs, cognitive and emotional perceptions using three different validated questionnaires. Beliefs about asthma medicine, cognitive and emotional factors were determined in a cross-sectional survey of patients attending outpatient pulmonologist practices in Latvia (n = 352). The validated Beliefs about Medicines Questionnaire and the Brief Illness Perception Questionnaire were used. Adherence to asthma medication was assessed using the Morisky Medication Adherence Scale and two different versions of the Medication Adherence Reporting Scale. Several questions about necessity or concerns related to pharmaceutical treatment were able to predict poor adherence according to the Morisky scale. If the patient felt that without the asthma medication his life would be impossible, his risk to have poor treatment adherence was 46% reduced (odds ratio 0.54; 95% confidence interval 0.33-0.89). Furthermore, asthma patients who were convinced that their health depends on the asthma treatment were less likely to have poor treatment adherence (odds ratio 0.56: 95% confidence interval 0.32-0.97). In case the patient was concerned by the need to constantly use asthma medication or sometimes concerned by long-term effects of asthma medication the odds of poor treatment adherence were 1.96 (95% confidence interval 1.19-3.24) and 2.43 (95% confidence interval 1.45-4.08), respectively. In conclusion, medication beliefs, particularly concerns and necessity of asthma treatment were associated with poor treatment adherence when assessed with the Morisky or 5-item Medication Adherence Reporting Scale.
INVESTIGATING POOR ADHERENCE IN THE LATVIAN POPULATION: Concerns about treatment necessity and uses of asthma medication are key factors influencing poor treatment adherence in Latvia. There are multiple psychological and behavioral reasons why patients do not adhere to asthma treatment courses, including social and religious beliefs, and perceptions of chronic illness. Patient questionnaires and 'adherence scales' can help predict whether patients are likely to follow advice, but their efficacy differs for individual nations. Dins Smits at Riga Stradins University, Latvia, and co-workers analyzed responses to three questionnaires completed by 352 asthma patients to assess treatment perceptions and the best questionnaire option for the Latvian population. Concerns about the use of asthma medication and beliefs about treatment necessity were key factors in poor adherence. These were picked up by the Morisky and MARS 5-item scales, which the authors recommend for future use.
哮喘控制的主要挑战之一是坚持药物治疗。本研究的目的是使用三种不同的经过验证的问卷来测试哮喘药物依从性、控制和医疗信念、认知和情绪感知之间的关联。在拉脱维亚的门诊肺病医生诊所（n=352）进行的横断面调查中，确定了对哮喘药物的信念、认知和情感因素。使用经过验证的药物信念问卷和简短疾病感知问卷。使用 Morisky 药物依从性量表和药物依从性报告量表的两个不同版本评估哮喘药物的依从性。根据 Morisky 量表，与药物治疗相关的一些关于必要性或担忧的问题能够预测不良依从性。如果患者认为没有哮喘药物他的生活将无法继续，那么他治疗依从性差的风险降低了 46%（优势比 0.54；95%置信区间 0.33-0.89）。此外，坚信自己的健康取决于哮喘治疗的哮喘患者不太可能出现治疗依从性差（优势比 0.56：95%置信区间 0.32-0.97）。如果患者对需要经常使用哮喘药物感到担忧，或者有时对哮喘药物的长期影响感到担忧，那么治疗依从性差的几率分别为 1.96（95%置信区间 1.19-3.24）和 2.43（95%置信区间 1.45-4.08）。总之，使用 Morisky 或 5 项药物依从性报告量表评估时，药物信念，特别是对哮喘治疗的必要性和关注与治疗依从性差有关。在拉脱维亚，有多个心理和行为因素会导致患者不遵守哮喘治疗方案，包括社会和宗教信仰以及对慢性病的看法。患者问卷和“依从性量表”可以帮助预测患者是否有可能遵循建议，但它们在不同国家的效果不同。拉脱维亚里加斯特雷丁斯大学的 Dins Smits 及其同事分析了 352 名哮喘患者完成的三份问卷的答案，以评估治疗认知和最适合拉脱维亚人群的问卷选项。对哮喘药物使用的担忧和对治疗必要性的信念是治疗依从性差的关键因素。这些因素在 Morisky 和 MARS 5 项量表中得到了体现，作者建议在未来的研究中使用这些量表。
