Smits Dins, Brigis Girts, Pavare Jana, Urtane Inga, Kovalovs Sandis, Barengo Noël Christopher
1Faculty of Public Health and Social Welfare, Riga Stradins University, Marupes 30, Riga, 1002 Latvia.
2Faculty of Medicine, Riga Stradins University, Riga, Latvia.
Allergy Asthma Clin Immunol. 2020 Mar 4;16:16. doi: 10.1186/s13223-020-0414-6. eCollection 2020.
The problem of nonadherence to therapy is a key reason of insufficient asthma control. Evaluating the beliefs about asthma medication, cognitive and emotional perceptions may help to identify patients with poor adherence to treatment in clinical practice which need additional attention in order to increase the likelihood of them taking their asthma medication according to the prescribed treatment protocol. The purpose of this study is to assess whether beliefs about asthma medication, cognitive and emotional factors are related to poor treatment adherence of asthma medication in a sample of asthma patients in Latvia.
Study subjects were asthma patients attending outpatient pulmonologist consultations in Latvia during September 2013 to December 2015. Beliefs about asthma medicine, cognitive and emotional factors related to asthma were determined in a cross-sectional, self-administered survey. The validated Beliefs about Medicines Questionnaire (BMQ) and the Brief Illness Perception Questionnaire (brief IPQ) were used. Treatment adherence was assessed using 5-item version of the Medication Adherence Reporting Scale (MARS). The total sample size was 352 patients. Logistic regression models were used to predict poor adherence to asthma treatment. The validity of each logistic regression model was assessed by the Hosmer/Lemeshow test. The main outcome measure was self-reported adherence to treatment.
The more the patients agreed with the statement "My future health depends on my asthma medication" the lower the possibility of poor adherence to asthma treatment (OR 0.42; 95% CI 0.24-0.74). The more concerned the patients were in regard to long-term effects of their medication (OR 2; 95% CI 1.22-3.27), the higher the probability of poor treatment adherence.
Screening asthma patients using the BMQ may help to identify those to benefit from interventions targeting their concerns and medication beliefs in order to improve adherence to asthma medication.
治疗依从性问题是哮喘控制不佳的关键原因。评估对哮喘药物的信念、认知和情感认知，有助于在临床实践中识别出治疗依从性差的患者，这些患者需要额外关注，以提高他们按照规定治疗方案服用哮喘药物的可能性。本研究的目的是评估在拉脱维亚的哮喘患者样本中，对哮喘药物的信念、认知和情感因素是否与哮喘药物治疗依从性差有关。
研究对象为2013年9月至2015年12月期间在拉脱维亚门诊接受肺科医生会诊的哮喘患者。通过横断面自填式调查确定对哮喘药物的信念、与哮喘相关的认知和情感因素。使用经过验证的药物信念问卷（BMQ）和简短疾病认知问卷（简短IPQ）。使用药物依从性报告量表（MARS）的5项版本评估治疗依从性。总样本量为352名患者。使用逻辑回归模型预测哮喘治疗依从性差。通过Hosmer/Lemeshow检验评估每个逻辑回归模型的有效性。主要结局指标是自我报告的治疗依从性。
患者越同意“我的未来健康取决于我的哮喘药物”这一说法，哮喘治疗依从性差的可能性就越低（比值比0.42；95%置信区间0.24 - 0.74）。患者对药物长期影响的担忧越多（比值比2；95%置信区间1.22 - 3.27），治疗依从性差的概率就越高。
使用BMQ筛查哮喘患者可能有助于识别那些将从针对其担忧和药物信念的干预措施中受益的患者，从而提高哮喘药物的依从性。
