Researchers from Northern Ireland have found that a significant proportion of patients with difficult-to-control asthma do not adhere to prescribed corticosteroid therapy.
Researcher studied 182 patients with difficult-to-control asthma to identify whether they requested repeat prescriptions for inhaled combination therapy and short-acting beta-agonists. Blood plasma prednisolone and cortisol assay levels were used to assess adherence to oral prednisolone. Factors including hospital admissions, lung function, oral prednisolone courses, and quality of life data were analyzed to indentify variables associated with reduced medication adherence.
Sixty-three patients (35%) filled 50% or fewer inhaled medication prescriptions; 88% admitted poor adherence with inhaled therapy after initially denying this. Twenty-one percent of patients filled more than 100% of presciptions, and 45% of subjects filled between 51 and 100% of prescriptions. 45% of patients who were prescribed oral steroids did not take their medicines as prescribed.
The authors recommend that adherence to medicines should be assessed before more expensive and aggressive treatments are considered for patients with difficult to treat asthma.
American Journal of Respiratory and Critical Care Medicine (2009); 180: 817-822