Factors associated with medication adherence among adults with asthma

Asthma medication adherence is of crucial importance for successful disease management. The aim of this study was to identify and rank factors associated with medication adherence among adults with asthma in the general population.
We used data on physician-diagnosed asthma, medication adherence, and factors associated with asthma medication adherence from the Danish General Suburban Population Study using a cross-sectional study design. We ranked factors associated with asthma medication adherence based on the magnitude of odds ratios, and the population attributable fractions.
Among 20,032 individuals from the general population, 1,128 (6%) suffered from asthma and 822 (73%) of these were adherent to asthma medications. Based on odds ratios, the three top-ranked factors associated with asthma medication adherence were asthma attacks within the past year (4.0; 95% CI: 2.9–5.5), allergy medication use (3.8; 2.6–5.6), and age above median (3.4; 2.4–4.7), followed by asthma severity markers like airway obstruction, and coughing with mucus. Based on population attributable fractions, the three top-ranked factors associated with adherence to asthma medications were asthma attacks within the past year (70%), age above median (57%), and use of allergy medication (49%).
The study showed that in the general population recent asthma attacks, higher age, and taking allergy medication were the three most important factors associated with asthma medication adherence. The importance of maintaining adherence to asthma medications even in the absence of severe disease or expressed asthma symptoms should be better communicated to the general population.

哮喘用药依从性对于疾病的成功管理至关重要。本研究旨在识别并排序普通人群中成年哮喘患者与用药依从性相关的影响因素。

本研究采用横断面研究设计，利用丹麦郊区普通人群研究（Danish General Suburban Population Study）的数据，该数据集涵盖经医师确诊的哮喘、用药依从性以及与哮喘用药依从性相关的各类影响因素。研究基于比值比（odds ratios）的大小与人群归因分值（population attributable fractions），对与哮喘用药依从性相关的影响因素进行排序。

在来自普通人群的20032名个体中，共有1128名（6%）罹患哮喘，其中822名（73%）患者坚持哮喘用药。基于比值比，与哮喘用药依从性相关的排名前三的因素依次为：过去1年内发生哮喘急性发作（4.0；95%置信区间CI：2.9–5.5）、使用抗过敏药物（3.8；2.6–5.6）以及年龄高于人群中位数（3.4；2.4–4.7），后续依次为气道阻塞、咳痰等哮喘严重程度相关指标。基于人群归因分值，与哮喘用药依从性相关的排名前三的因素分别为：过去1年内发生哮喘急性发作（70%）、年龄高于人群中位数（57%）以及使用抗过敏药物（49%）。

本研究表明，在普通人群中，近期哮喘急性发作、高龄以及使用抗过敏药物是与哮喘用药依从性相关的三大核心影响因素。应向普通人群更有效地宣传坚持哮喘用药的重要性，即便患者未出现重症或明确的哮喘症状也应如此。