Rackow Pamela, Drennan Amelia, Pinnock Hilary, Dima Alexandra L
University of Stirling, Faculty of Natural Sciences, Psychology, Stirling.
Usher Institute, The University of Edinburgh, Edinburgh, UK.
Curr Opin Pulm Med. 2025 May 1;31(3):262-269. doi: 10.1097/MCP.0000000000001166. Epub 2025 Mar 19.
Adherence to medication is essential for asthma control and reducing the risk of exacerbations. Research has accumulated in recent years on causes and consequences of adherence and effective interventions. This review highlights current advances in adherence research and their potential for clinical practice.
Optimizing adherence to medication can be achieved through interventions that identify individual barriers and train the care team in offering tailored support. Digital technologies that facilitate remote monitoring, patient-provider communication and care coordination are increasingly being integrated into asthma care.
Adherence determinants reported cover individual, social and health service-related factors. Age and attitudes toward adherence are crucial determinants. Patients' and caregivers' mental health is relevant for adherence and clinical outcomes, highlighting the importance of integrating this aspect into holistic asthma management. Single-site care arrangements are beneficial for adherence. Tailoring adherence interventions to individual needs, using brief questionnaires to assess barriers and recommending evidence-based strategies to address them, have been found useful and feasible across care settings. Digital technologies such as smart inhaler systems and telemedicine-enhanced care have been shown to be effective in randomized controlled trials, yet implementation research highlights challenges to sustaining support on the long-term.
坚持用药对于哮喘控制和降低急性发作风险至关重要。近年来，关于坚持用药的原因、后果及有效干预措施的研究不断积累。本综述重点介绍坚持用药研究的当前进展及其在临床实践中的潜力。
通过识别个体障碍并培训护理团队提供个性化支持的干预措施，可以实现优化用药依从性。促进远程监测、患者与提供者沟通以及护理协调的数字技术正越来越多地融入哮喘护理中。
报告的坚持用药决定因素涵盖个体、社会和与健康服务相关的因素。年龄和对坚持用药的态度是关键决定因素。患者和护理人员的心理健康与坚持用药及临床结果相关，这凸显了将这一方面纳入整体哮喘管理的重要性。单点护理安排有利于坚持用药。根据个体需求定制坚持用药干预措施，使用简短问卷评估障碍并推荐基于证据的策略来解决这些障碍，已发现在各种护理环境中都是有用且可行的。智能吸入器系统和远程医疗强化护理等数字技术在随机对照试验中已被证明是有效的，但实施研究凸显了长期维持支持方面的挑战。
