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
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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