Objective To identify the risk factors that influence patient adherence with the prescribed medication and their association with asthma control.
Methodology Total 310 children with persistent asthma from inpatient and outpatient department of children hospital were included in this study. The medication adherence was assessed by using Morisky medication adherence assessment questionnaire (MMAS).Children were classified as having well controlled, partially controlled or uncontrolled asthma based on Gina guidelines. Data was analysed using SPSS version 20.
Results Out of 310 children 202 (65%) were male and 108 (34.83%) were female. Mean age was 8.9±3.5 years. Total 231 (74.5%) belong to poor socioeconomic status, 71 (22.9%) to middle class and 8 (2.6%) to upper class. Regarding the asthma control 66 (21.3%) were having well controlled asthma, 71 (22.9%) partially controlled and 173 (55.8%) uncontrolled asthma. Low adherence i.e (MMAS score <6) was found in 138 (44.5%), medium adherence (MMAS score 6–8) in 71 (22.9%), and high adherence (MMAS score=8) in 101 (32.6%) of children. Poor adherence was found to be significantly associated with level of asthma control (p=0.05). Similarly poor socioeconomic status was associated with poor adherence in these children (p=0.04). Caregiver education had no significant impact on adherence level i.e (p=0.83). However poor understanding of treatment regimen, high cost of medication and alternative medication usage in the form of homeopathy, home remedies were found to be significantly associated with poor adherence in the children i.e (p=0.015, p=0.05, p=0.014) respectively.
Conclusion Adherence with medication regimen is essential for attaining maximal therapeutic benefits. Poor socioeconomic status, poor understanding of treatment regimen, high cost of medication and alternative medication use are important risk factors for poor adherence to medication leading to uncontrolled asthma. It is important to incorporate strategies in asthma treatment plan to improve patient adherence.
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