Adherence to inhalers and associated factors among adult asthma patients: an outpatient-based study in a tertiary hospital of Rajshahi, Bangladesh

Asthma Res Pract. 2022 Feb 9;8(1):1. doi: 10.1186/s40733-022-00083-7.

Abstract

Background: Adherence to inhaler medication is an important contributor to optimum asthma control along with adequate pharmacotherapy. The objective of the present study was to assess self-reported adherence levels and to identify the potential factors associated with non-adherence to the inhalers among asthma patients.

Methods: This facility-based cross-sectional study was conducted in the medicine outpatient department of Rajshahi Medical College Hospital from November 2020 to January 2021. A total of 357 clinically confirmed adult asthma patients were interviewed. Inhaler adherence was measured using the 10-item Test of Adherence scale (TAI).. Both descriptive and inferential statistics were used to express the socio-demographic of the patients and predictors of poor adherence to inhaler.

Results: A substantial number of participants were non-adherent (86%) to inhaler medication. Patients non-adherent to inhaler medication are often younger (23.15, 95% CI 3.67-146.08), lived in the rural area (23.28, 95% CI 2.43-222.66), less year of schooling (5.69, 95% CI 1.27-25.44), and belonged to the middle income (aOR 9.74, 95% CI 2.11-44.9) than those adherent with the inhaler. The presence of comorbidities (12.91, 95% CI 1.41-117.61), prolonged duration of inhaler intake (5.69, 95% CI 1.22-26.49), consulting non-qualified practitioners (13.09, 95% CI 3.10-55.26) were the significant contributor of non-adherence.

Conclusion: Despite ongoing motivation and treatment, non-adherence to inhalation anti-asthmatic is high and several factors have been found to contribute. Regular monitoring and a guided patient-centered self-management approach might be helpful to address them in long run.

Keywords: Adherence; Anti-asthmatic agents; Asthma; Drug compliance; Inhaler; Medication nonadherence; Obstructive lung disease.