Journal of General Internal Medicine

, Volume 28, Issue 1, pp 67–73

Asthma Beliefs Are Associated with Medication Adherence in Older Asthmatics

  • Anastasia Sofianou
  • Melissa Martynenko
  • Michael S. Wolf
  • Juan P. Wisnivesky
  • Katherine Krauskopf
  • Elizabeth A. H. Wilson
  • Mita Sanghavi Goel
  • Howard Leventhal
  • Ethan A. Halm
  • Alex D. Federman
Original Research

DOI: 10.1007/s11606-012-2160-z

Cite this article as:
Sofianou, A., Martynenko, M., Wolf, M.S. et al. J GEN INTERN MED (2013) 28: 67. doi:10.1007/s11606-012-2160-z

Abstract

BACKGROUND

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.

OBJECTIVE

To explore the relationship of asthma-related beliefs and self-reported controller medication adherence in older asthmatics.

DESIGN

An observational study of asthma beliefs and self-management among older adults.

PARTICIPANTS

Asthmatics ages ≥60 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.

MAIN MEASURES

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.

KEY RESULTS

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.

CONCLUSIONS

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.

KEY WORDS

asthma disease management medication adherence aging health beliefs. 

Abbreviation List

NIA

National Institute on Aging

CSM

Common Sense Model of Self Regulation

FQHC

Federally Qualified Health Center

COPD

Chronic Obstructive Pulmonary Disease

ICS

Inhaled Corticosteroids

LTI

Leukotriene Inhibitors

MARS

Medication Adherence Report Scale

B-IPQ

Brief Illness Perceptions Questionnaire

BMQ

Beliefs about Medications Questionnaire

Supplementary material

11606_2012_2160_MOESM1_ESM.doc (56 kb)
ESM 1(DOC 55 kb)

Copyright information

© Society of General Internal Medicine 2012

Authors and Affiliations

  • Anastasia Sofianou
    • 1
  • Melissa Martynenko
    • 1
  • Michael S. Wolf
    • 3
  • Juan P. Wisnivesky
    • 1
    • 2
  • Katherine Krauskopf
    • 1
  • Elizabeth A. H. Wilson
    • 3
  • Mita Sanghavi Goel
    • 3
  • Howard Leventhal
    • 4
  • Ethan A. Halm
    • 5
  • Alex D. Federman
    • 1
  1. 1.Division of General Internal MedicineMount Sinai School of MedicineNew YorkUSA
  2. 2.Division of Pulmonary, Critical Care, and Sleep MedicineMount Sinai School of MedicineNew YorkUSA
  3. 3.Feinberg School of MedicineNorthwestern UniversityChicagoUSA
  4. 4.Institute for Health, Health Care Policy and Aging Research, RutgersThe State University of New JerseyNewarkUSA
  5. 5.Division of General Internal MedicineUniversity of Texas Southwestern Medical CenterDallasUSA

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