Poor compliance to inhaler therapy in bronchial asthma patients –a prospective study in general population

Background: Considering the prevalence and associated burden of disease due to bronchial asthma, it is mandatory to obtain an optimal control of the disease and to improve outcomes for these patients. Asthma control and treatment compliance are widely investigated issues around the world. But it has been observed that there is very poor adherence to the inhalational therapy which leads to the sub-optimal control of the disease. Objectives of the study: To investigate the adherence for anti-asthma inhalational medications in adults with bronchial asthma. Methodology: A prospective study was done in a total of 400 bronchial asthma patients over a period of 2 years. Once included in the study, the patients were followed up for a total of 12 weeks for calculation of non-adherence to the aerosol therapy. Results: A total of 400 patients of bronchial asthma who were started on inhalational therapy were included in the study. At the end of 12 weeks, it was observed that, only 154 patients (38.5%) had regular compliance and 246 patients (61.5%) were noncompliant to aerosol therapy as prescribed for bronchial asthma. Factors that were associated with poor compliance were: lower educational level status, poor socio-economic status, cumbersome regimens, dislike of medication and distant pharmacies. Non-Drug factors that reduced the compliance were: fears about side effects, anger about condition or its treatment, forgetfulness or complacency and patient’s ill attitudes toward health. Conclusion: Noncompliance in asthma management is a fact of life and no single compliance-improving strategy probably will be as effective as a good physician–patient relationship. Optimal self-management allowing for optimization of asthma control by adjustment of medications may be conducted by either self-adjustment with the aid of a written action plan or by regular medical review.