Poor Adherence: Teens’ Too Busy / Don’t Perceive Asthma Medication Benefits

Teenagers with asthma are “too busy” to use their medications and often do not believe in their benefits, say researchers who assessed health beliefs in young people with asthma. It has previously been suggested that poor adherence to asthma medications in individuals aged 15–20 years contributes substantially to asthma-related morbidity in that age group. However, there have been few adherence studies in this age group, despite the fact that the organizational and behavioral skills that largely determine adherence are developed during late adolescence. Furthermore, “no studies have specifically examined medication adherence and health beliefs among urban older adolescents, a population at particular risk of asthma,” write Andrea Apter (University of Pennsylvania, Philadelphia, USA) and co-workers. Apter and team conducted two semi-structured interviews, 1 month apart, about medication use with 40 asthmatic individuals aged 15–18 years, 30 of whom were African American. Discussing the choice of study participants, Apter and team explain that “among 15- to 19-year-olds with asthma, Black individuals have three times the emergency department (ED) visits, over four times the hospitalizations, and five times the death rate of White individuals.” Adherence to fluticasone/salmeterol was also monitored electronically in the month between interviews. The median adherence rate among the adolescents was 43% and ranged from 4% to 89%. Surprisingly, lung function measured by FEV1 and visits to the ED were approximately the same regardless of adherence rate. Interviews confirmed that most teens used their medications intermittently despite understanding that they were designed to help them breathe more easily. This was often because they were “too busy” or because they “disliked the taste,” or, in 20% of cases, because they thought their medications were unnecessary. “An important lesson is that providers might benefit from including similar one-on- one time with teens to facilitate communication.” (Source: J Allergy Clin Immunol 2009; 123: 1335–1341)
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