BACKGROUND: Adherence to inhaled steroid regimens for asthma is poor in adults and children. Although it is assumed that nonadherence contributes to morbidity in older adolescents, investigation is limited. OBJECTIVE: We sought to describe adherence to preventive asthma medications and explore relevant beliefs and attitudes in older urban adolescents, including their ideas for improving adherence. METHODS: Quantitative and qualitative methods were used to collect data from a convenience sample of adolescents with asthma previously prescribed fluticasone/salmeterol (F/S). Two semistructured face-to-face interviews were conducted 1 month apart and analyzed for themes. F/S use was electronically monitored between visits and calculated as the number of actuations divided by the number of inhalations prescribed. RESULTS: Forty participants, (15-18 years of age, 19 female subjects, 30 black/African American subjects, 11 Medicaid-insured subjects, and 24 previously hospitalized for asthma) with a median FEV1 of 98% of predicted value (range, 67% to 127%) had median adherence of 43% (range, 4% to 89%). Adherence was not associated with FEV1 or emergency department visits. Themes emerged from interviews as follows. Teens (1) take F/S inconsistently; (2) believe F/S is "supposed to help me breathe"; (3) dislike its taste; (4) are "too busy" and "forget"; and (5) recommend "reminder" solutions to poor adherence. Twenty percent believed that taking F/S was unnecessary, and another 18% expressed ambivalence about its benefits. CONCLUSION: Adherence was poor. Examining and acknowledging health beliefs of older teens in the context of their complicated lives might facilitate discussions about self-management.
BACKGROUND: Adherence to inhaled steroid regimens for asthma is poor in adults and children. Although it is assumed that nonadherence contributes to morbidity in older adolescents, investigation is limited. OBJECTIVE: We sought to describe adherence to preventive asthma medications and explore relevant beliefs and attitudes in older urban adolescents, including their ideas for improving adherence. METHODS: Quantitative and qualitative methods were used to collect data from a convenience sample of adolescents with asthma previously prescribed fluticasone/salmeterol (F/S). Two semistructured face-to-face interviews were conducted 1 month apart and analyzed for themes. F/S use was electronically monitored between visits and calculated as the number of actuations divided by the number of inhalations prescribed. RESULTS: Forty participants, (15-18 years of age, 19 female subjects, 30 black/African American subjects, 11 Medicaid-insured subjects, and 24 previously hospitalized for asthma) with a median FEV1 of 98% of predicted value (range, 67% to 127%) had median adherence of 43% (range, 4% to 89%). Adherence was not associated with FEV1 or emergency department visits. Themes emerged from interviews as follows. Teens (1) take F/S inconsistently; (2) believe F/S is "supposed to help me breathe"; (3) dislike its taste; (4) are "too busy" and "forget"; and (5) recommend "reminder" solutions to poor adherence. Twenty percent believed that taking F/S was unnecessary, and another 18% expressed ambivalence about its benefits. CONCLUSION: Adherence was poor. Examining and acknowledging health beliefs of older teens in the context of their complicated lives might facilitate discussions about self-management.
Authors: B Bender; F S Wamboldt; S L O'Connor; C Rand; S Szefler; H Milgrom; M Z Wamboldt Journal: Ann Allergy Asthma Immunol Date: 2000-11 Impact factor: 6.347
Authors: Giselle Mosnaim; Hong Li; Molly Martin; DeJuran Richardson; Paula Jo Belice; Elizabeth Avery; Norman Ryan; Bruce Bender; Lynda Powell Journal: J Allergy Clin Immunol Pract Date: 2013-08-30
Authors: Anne Fuhlbrigge; David Peden; Andrea J Apter; Homer A Boushey; Carlos A Camargo; James Gern; Peter W Heymann; Fernando D Martinez; David Mauger; William G Teague; Carol Blaisdell Journal: J Allergy Clin Immunol Date: 2012-03 Impact factor: 10.793
Authors: Giselle Mosnaim; Hong Li; Molly Martin; Dejuran Richardson; Paula Jo Belice; Elizabeth Avery; Norman Ryan; Bruce Bender; Lynda Powell Journal: Ann Allergy Asthma Immunol Date: 2013-12-21 Impact factor: 6.347