Asthma patients' and physicians’ perspectives on the burden and management of asthma: Post-hoc analysis of APPaRENT 1 and 2 to assess predictors of treatment adherence - 20/05/24
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Abstract |
Introduction |
Patient adherence to maintenance medication is critical for improving clinical outcomes in asthma and is a recommended guiding factor for treatment strategy. Previously, the APPaRENT studies assessed patient and physician perspectives on asthma care; here, a post-hoc analysis aimed to identify patient factors associated with good adherence and treatment prescription patterns.
Methods |
APPaRENT 1 and 2 were cross-sectional online surveys of 2866 adults with asthma and 1883 physicians across Argentina, Australia, Brazil, Canada, China, France, Italy, Mexico, and the Philippines in 2020–2021. Combined data assessed adherence to maintenance medication, treatment goals, use of asthma action plans, and physician treatment patterns and preferences. Multivariable logistic regression models assessed associations between patient characteristics and both treatment prescription (by physicians) and patient treatment adherence.
Results |
Patient and physician assessments of treatment goals and adherence differed, as did reporting of short-acting β2-agonist (SABA) prescriptions alongside maintenance and reliever therapy (MART). Older age and greater patient-reported severity and reliever use were associated with better adherence. Patient-reported prescription of SABA with MART was associated with household smoking, severe or poorly controlled asthma, and living in China or the Philippines.
Conclusions |
Results revealed an important disconnect between patient and physician treatment goals and treatment adherence, suggesting that strategies for improving patient adherence to maintenance medication are needed, focusing on younger patients with milder disease. High reliever use despite good adherence may indicate poor disease control. Personalised care considering patient characteristics alongside physician training in motivational communication and shared decision-making could improve patient management and outcomes.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Post-hoc analysis of global APPaRENT 1 & 2 survey data assessed patient adherence. |
• | Adherence was associated with higher age, disease severity, and reliever use. |
• | Patient and physician perspectives on adherence and treatment strategies differ. |
• | Physician–patient communication training may improve expectations and adherence. |
• | Personalised care may improve patient adherence and clinical outcomes. |
Keywords : 3–6): Treatment adherence, Inhalation therapy, Physician–patient relations, Patient engagement
Abbreviations : aOR, CI, GINA, GP, ICS, LABA, MART, PRD, SABA, SD
Plan
Vol 227
Article 107637- juin 2024 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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