Keeping asthma medication in the bathroom and incorporating its use into daily routines are strategies associated with good medication adherence in older adults with asthma, US research shows.
“Clinicians concerned with adherence should consider recommending these strategies to their older asthmatic patients, although additional research is needed to determine whether such advice would improve adherence behaviors”, write Alex Federman (Mount Sinai School of Medicine, New York) and colleagues in the Journal of General Internal Medicine.
The researchers questioned 358 asthma patients (mean age 67.5 years, 84% women) on their adherence to inhaled corticosteroids, what they did to remember to take their medication and their beliefs about the duration and curability of asthma.
The majority of study participants said they would always have asthma and that their doctor could not cure asthma. In addition, most believed the benefits of inhaled corticosteroid use outweighed the risks.
In spite of this, the rate of good medication adherence, defined as a mean Medication Adherence Rating Scale score of 4.5 or above, was low overall, at 37%.
After adjustment for demographic characteristics, physical and mental health and asthma beliefs, Federmen and team found that patients who stored their medication in the bathroom (9.2%) were 3.1 times more likely to have good adherence than those who stored their medication in other specific locations (37.4%), including the bedside, which was the most common storage location (20.1%).
Patients who integrated medication use into their daily routine (32.6%) were 3.8 times more likely to have good adherence than those who did not.
The researchers note that these strategies were less likely to be used by patients with low incomes, limited English proficiency, low health literacy, poor physical health, depression, anxiety and erroneous asthma beliefs, but were more likely to be employed by White patients, those who had at least a partial college education and those born in the USA.
Additional adherence strategies reported by the patients included taking the medication at a specific time of day (21.7%), taking the medication with other medications (13.4%), using the medication only when needed (13.4%) and using other reminders (11.9%), but none of these were significantly associated with good medication adherence.
“Because adherence strategies are modifiable, the findings in this study may provide clinicians and care coaches with straightforward and useful messages to help older patients improve their medication adherence”, Federman and co-authors conclude.
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