Asthma Beliefs Are Associated with Medication Adherence in Older Asthmatics
Asthma Beliefs Are Associated with Medication Adherence in Older Asthmatics
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DOI：
10.1007/s11606-012-2160-z
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发表时间：
2013-01-01
影响因子：
5.7
通讯作者：
Federman, Alex D.
中科院分区：
文献类型：
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作者：
Sofianou, Anastasia;Martynenko, Melissa;Federman, Alex D.
尽管老年哮喘患者的发病率和死亡率较高，但哮喘的实证研究和卫生政策主要集中在儿童和年轻人身上。探讨老年哮喘患者的哮喘相关信念和自我报告的控制药物依从性之间的关系。老年人哮喘信念和自我管理的观察性研究。哮喘患者的年龄为60岁。从纽约市和芝加哥的初级保健实践中招募了324名受试者（N = 324，平均年龄67.4 ± 6.8，28%为白色，32%为黑人，30%为西班牙裔）。根据自我调节的常识模型，患者被问及他们是否相信他们只有症状的哮喘，他们的医生可以治愈他们的哮喘，以及他们的哮喘是否会持续下去。还评估了对使用治疗的益处、必要性和关注点的看法。采用多因素Logistic回归分析信念与自我报告的药物依从性之间的关系，大多数（57.0%）患者报告依从性差。自我报告的依从性差在那些对哮喘疾病和治疗有错误信念的人中更常见，包括“没有症状，就没有哮喘”的信念（58.7% vs. 31.7%，p < 0.001），“不会一直有哮喘”的信念（34.8%对12.5%，p < 0.001），以及“MD可以治愈哮喘”的信念（21.7%对9.6%，p = 0.01）。调整疾病信念、治疗信念和人口统计学，具有“无症状，无哮喘”信念的患者自我报告依从性良好的几率较低（比值比[OR] 0.45，95%置信区间[CI] 0.23-0.86），对益处持负面看法的人也是如此。（OR 0.73，95%CI 0.57-0.94）和治疗必要性（OR 0.89，95%CI 0.83-0.96）。通过改变疾病和治疗信念来改善老年哮喘患者的药物依从性的干预措施值得研究。
Empirical research and health policies on asthma have focused on children and young adults, even though asthma morbidity and mortality are higher among older asthmatics.To explore the relationship of asthma-related beliefs and self-reported controller medication adherence in older asthmatics.An observational study of asthma beliefs and self-management among older adults.Asthmatics ages a parts per thousand yen60 years (N = 324, mean age 67.4 +/- 6.8, 28 % white, 32 % black, 30 % Hispanic) were recruited from primary care practices in New York City and Chicago.Self-reported controller medication adherence was assessed using the Medication Adherence Report Scale. Based on the Common Sense Model of Self-Regulation, patients were asked if they believe they only have asthma with symptoms, their physician can cure their asthma, and if their asthma will persist. Beliefs on the benefit, necessity and concerns of treatment use were also assessed. Multivariate logistic regression was used to examine the association of beliefs with self-reported medication adherence.The majority (57.0 %) of patients reported poor adherence. Poor self-reported adherence was more common among those with erroneous beliefs about asthma illness and treatments, including the "no symptoms, no asthma" belief (58.7 % vs. 31.7 %, respectively, p < 0.001), "will not always have asthma" belief (34.8 % vs. 12.5 %, p < 0.001), and the "MD can cure asthma" belief (21.7 % vs. 9.6 %, p = 0.01). Adjusting for illness beliefs, treatment beliefs and demographics, patients with a "no symptoms, no asthma" belief had lower odds of having good self-reported adherence (odds ratio [OR] 0.45, 95 % confidence interval [CI] 0.23-0.86), as did those with negative beliefs about the benefits (OR 0.73, 95 % CI 0.57-0.94) and necessity (OR 0.89, 95 % CI 0.83-0.96) of treatment.Illness and treatment beliefs have a strong influence on self-reported medication adherence in older asthmatics. Interventions to improve medication adherence in older asthmatics by modifying illness and treatment beliefs warrant study.