Influence factors of treatment compliance in adult asthma patients in Shanghai

Objective To investigate the treatment compliance and influencing factors of adult asthma patients in Shanghai. Methods A multi-center cross-sectional study was conducted to investigate adult asthma patients who were reexamined in outpatient clinics of 9 hospitals in Shanghai.Questionnaires included the basic information of patients, disease awareness, Morisky medication adherence questionnaire, the use of asthma drugs, and the reasons for non-compliance.According to Morisky score, 499 asthmatic patients treated with inhaled glucocorticoids were divided into two groups: the poor compliance group (Morisky score <6) and the better compliance group (Morisky score <6). The two groups were compared. Results There were 259 cases (51.9%) in poor compliance group and 240 cases (48.1%) in better compliance group.Compared with the better compliance group, the poor compliance group had a higher proportion of patients in the 18-30 age group and specialized clinic (χ2=6.331, 8.983, both P<0.05), while the proportion of patients in the 50-70 age group and expert clinic was lower (χ2=8.088, 4.711, both P<0.05). The correction rate of the first to fifth items of asthma knowledge in poor compliance group was significantly lower than that in the group with better compliance (χ2=19.860, 4.711, 5.345, 27.677, 24.975, all P<0.05). And the proportion of patients who knew less than (or equal to) 2 items increased significantly in poor compliance group (χ2=20.980, P<0.01). Compared with the group with better compliance, the proportion of inhaled short-acting bronchodilator, oral compound methoxyphenamine and traditional Chinese medicine treatment use were higher in the group with poor compliance (χ2=6.449, 5.208, 5.933, all P<0.05). The proportion of patients use more than 4 kinds of medications for treating asthma in poor compliance group was significantly higher than in better compliance group (χ2=20.980, P<0.01). The proportion of patients in poor compliance group who did not comply with doctor′s advice because of conscious improvement, forgetting medication, unwilling to use inhalation for a long time, fear of drug dependence, difficulty in long-term persistence and troublesome device use was significantly higher than that in better compliance group (χ2=59.842, 45.303, 20.607, 18.163, 33.659, 9.26, all P<0.01), and the proportion of patients who did not comply with doctor′s advice due to poor drug efficacy was also higher (χ2=4.452, P<0.05). Conclusions Asthma treatment compliance in Shanghai is less than 50%.The main causes include insufficient awareness of long-term treatment of asthma, Conscious improvement of the condition, forgetting to use drugs, and reluctance to use inhalation for a long time.Corresponding measures should be taken to improve treatment compliance and achieve good control of asthma. Key words: Asthma; Medication adherence; Influence factor