Sasaki Jun, Kawayama Tomotaka, Yoshida Makoto, Takahashi Koichiro, Fujii Kazuhiko, Machida Kentaro, Kinoshita Takashi, Hoshino Tomoaki
a Department of Medicine, Division of Respirology, Neurology, and Rheumatology, Kurume University School of Medicine , Kurume , Japan.
b Respiratory Medicine, National Hospital Organization Fukuoka Hospital , Fukuoka , Japan.
J Asthma. 2019 Jun;56(6):632-641. doi: 10.1080/02770903.2018.1484132. Epub 2018 Sep 19.
We investigated adherence barriers to inhaled medicines among older compared to younger adults with asthma in Japan.
Adherence barriers to inhaled medicines were evaluated in 251 Japanese older (n = 138) and younger (n = 113) adults with asthma using the self-reporting "Adherence Starts with Knowledge 20" (ASK-20) questionnaire.
There were fewer older adults with poor adherence to inhaled medicines than younger adults. The ASK-20 questionnaire revealed (odds ratio [95% confidence interval]) item Q11 ("My doctor/nurse and I work together to make decisions"; 2.94 [1.31, 6.61]; p < 0.05) as an independent adherence barrier to inhaled medicines among older adults, whereas younger adults reported item Q3 ("My use of alcohol gets in the way of taking my medicines"; 3.91 [1.02 to 15.1]; p < 0.05) and item Q16 ("Taken a medicine more or less often than prescribed? "; 2.31 [1.32 to 4.06]; p < 0.05) as barriers. Older adults with poor adherence identified item Q1 ("I just forget to take my inhaled medicines some of the time"; 4.43 [1.77, 11.1]; p < 0.05) as a barrier, although the total ASK-20 scores and total barrier counts were significantly higher in older (both, p < 0.05) and younger (both, p < 0.05) adults with poor adherence than in those with good adherence.
Older Japanese patients had better adherence to inhaled medicines than younger patients. Barriers were different between older and younger adults. These results will help personalize education for inhaled medicines in Japanese asthmatics.
我们调查了日本老年与年轻哮喘患者吸入药物的依从性障碍。
采用自我报告的“依从性始于知识20”（ASK - 20）问卷，对251名日本老年（n = 138）和年轻（n = 113）哮喘患者的吸入药物依从性障碍进行评估。
吸入药物依从性差的老年患者比年轻患者少。ASK - 20问卷显示，问题11（“我的医生/护士和我共同做出决定”；比值比[95%置信区间]为2.94[1.31, 6.61]；p < 0.05）是老年患者吸入药物的独立依从性障碍，而年轻患者报告问题3（“我饮酒影响了服药”；3.91[1.02至15.1]；p < 0.05）和问题16（“服药次数比规定的多或少？”；2.31[1.32至4.06]；p < 0.05）为障碍。依从性差的老年患者认为问题1（“我有时就是忘了吸入药物”；4.43[1.77, 11.1]；p < 0.05）是障碍，尽管依从性差的老年患者和年轻患者的ASK - 20总分及总障碍数均显著高于依从性好的患者（均p < 0.05）。
日本老年患者比年轻患者对吸入药物的依从性更好。老年和年轻患者的障碍不同。这些结果将有助于针对日本哮喘患者进行吸入药物的个性化教育。
