Skip to main content

Advertisement

SpringerLink
Log in

Optimal Management of Asthma in Elderly Patients

Strategies to Improve Adherence to Recommended Interventions

  • Review Article
  • Published:
Drugs & Aging Aims and scope Submit manuscript

Abstract

Adherence to asthma medications presents a problem in all age groups, and older people with chronic illnesses such as asthma also have multiple co-morbidities and consequently complex healthcare needs. It has been suggested that older people are also less likely to adhere to medication and treatment than younger people. Although the prevalence of asthma in older people is similar to that of the general population, over two-thirds of those who die from asthma are >50 years of age and there is strong evidence for under-diagnosis. Clinicians therefore face specific challenges in providing healthcare with respect to both asthma diagnosis and treatment in older age groups. Non-adherence to medication can be defined as either ‘intentional’ or ‘unintentional’. Unintentional non-adherence is more likely to be associated with sociodemographic or physical barriers to the use of medication. Intentional non-adherence results from the balance of individual reasoning of risks versus the benefits of taking medication and acceptance of asthma diagnosis. Intentional non-adherence can be addressed through strategies that influence health beliefs and concerns about the adverse effects of medicine. Unintentional adherence can be addressed by assessing and educating the patient in relation to device use and providing education and clear written instructions about medication requirements. However, some barriers to medication use, such as financial ones, may be systematic. Most studies of medication use, efficacy, adverse effects and adherence in patients with asthma primarily involve younger people. Studies of strategies to improve asthma adherence outcomes specifically in older people are urgently needed.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Table I

Similar content being viewed by others

Explore related subjects

Discover the latest articles, news and stories from top researchers in related subjects.

References

  1. Global Initiative for Asthma (GINA). Asthma management and prevention: a practical guide for public health officials and health care professionals. London: Imperial College, GINA, 2001

    Google Scholar 

  2. Australian Centre for Asthma Monitoring. Asthma in Australia 2005. AIHW Asthma Series 2. AIHW cat. no. ACM 6. Canberra (ACT): AIHW, 2005

    Google Scholar 

  3. Campbell M, Cogman G, Holgate S, et al. Age specific trends in asthma mortality in England and Wales, 1983–95: results of an observational study. BMJ 1997; 314: 1439–41

    Article  PubMed  CAS  Google Scholar 

  4. Mannino DM, Homa DM, Akinbami LJ, et al. Surveillance for asthma-United States, 1980–1999. MMWR Surveill Summ 2002 Mar 29; 51(1): 1–13

    Google Scholar 

  5. Enright P, Kronmal R, Higgins M, et al. Prevalence and correlates of respiratory symptoms and disease in the elderly. Chest 1994; 106: 827–34

    Article  PubMed  CAS  Google Scholar 

  6. Kitch B, Levy B, Fanta C. Late onset asthma: epidemiology, diagnosis and treatment. Drugs Aging 2000; 17: 385–97

    Article  PubMed  CAS  Google Scholar 

  7. Wilson D, Appleton S, Adams R, et al. Undiagnosed asthma in older people: an underestimated problem. Med J Aust 2005; 183(1 Suppl.): S20–2

    PubMed  Google Scholar 

  8. Krishnan V, Diette G, Rand C, et al. Mortality in patients hospitalized for asthma exacerbations in the United States. Am J Respir Crit Care Med 2006; 174: 633–8

    Article  PubMed  Google Scholar 

  9. Guidelines for the diagnosis and management of asthma. Expert Panel Report II. NIH publication no. 97-4501. Bethesda (MD): National Institutes of Health, National Heart, Lung and Blood Institute, 1997

  10. Enright P. The diagnosis and management of asthma is much tougher in older patients. Curr Opin Allergy Clin Immunol 2002; 2: 175–81

    Article  PubMed  Google Scholar 

  11. Braman S. Drug treatment of asthma in the elderly. Drugs 1996; 51: 415–22

    Article  PubMed  CAS  Google Scholar 

  12. Renwick D, Connolly M. Improving outcomes in elderly patients with asthma. Drugs Aging 1999; 14(1): 1–9

    Article  PubMed  CAS  Google Scholar 

  13. Masood D, Cheriyan S, Patterson R. Management of asthma in the geriatric population. Gerontology 1996; 42: 183–9

    Article  PubMed  CAS  Google Scholar 

  14. Weiss S, Petty T. Special challenges in managing asthma in the elderly: keys to unmasking a ‘hidden’ ailment. Consultant 1998; 38: 686–90

    Google Scholar 

  15. Barua P, O’Mahony M. Overcoming gaps in the management of asthma in older patients. Drugs Aging 2005; 22: 1029–59

    Article  PubMed  CAS  Google Scholar 

  16. Dow L. The diagnosis of asthma in older people. Clin Exp Allergy 1994; 24: 156–9

    Article  PubMed  CAS  Google Scholar 

  17. Enright PL, McClelland RL, Newman AB, et al. Underdiagnosis and undertreatment of asthma in the elderly. Chest 1999; 116: 603–13

    Article  PubMed  CAS  Google Scholar 

  18. Braman S. Asthma in the elderly. Clin Geriatr Med 2003; 19: 57–75

    Article  PubMed  Google Scholar 

  19. Walters K, Illiffe S, Orrell M. An exploration of help-seeking behaviour in older people with unmet needs. Fam Pract 2001; 18: 277–82

    Article  PubMed  CAS  Google Scholar 

  20. Moore ST. Marketing ambulatory services to the elderly. J Hosp Mark 1991; 6: 121–9

    PubMed  CAS  Google Scholar 

  21. Abramson M. Respiratory symptoms and lung function in older people with asthma or chronic obstructive pulmonary disease. Med J Aust 2005; 183(1 Suppl.): S23–5

    PubMed  Google Scholar 

  22. Dow L. Asthma in older people. Clin Exp Allergy 1998; 28: 195–202

    Article  PubMed  Google Scholar 

  23. Morris M. Difficulties with diagnosing asthma in the elderly. Chest 1999; 116: 591–3

    Article  PubMed  CAS  Google Scholar 

  24. Bashoura L, Hanania N. Cough may be the only presenting symptom: confronting the challenges of asthma in the elderly patient. J Respir Dis 2004; 25: 310–6

    Google Scholar 

  25. Asthma management handbook 2002. South Melbourne (VIC): National Asthma Council Australia (NACA), 2002

  26. Global Initiative for Asthma (GINA). Pocket guide for asthma management and prevention: a pocket guide for physicians and nurses. Revised 2006 Dec. Bethesda (MD): Global Initiative for Asthma, National Heart, Lung, and Blood Institute, 2006 [online]. Available from URL: http://www.ginasthma.org/Guidelineitem.asp?ll=2&12=l&intld=37 [Accessed 2007 May 1]

    Google Scholar 

  27. Campbell DA, Luke CG, McLennan G, et al. Near-fatal asthma in South Australia: descriptive features and medication use. Aust N Z J Med 1996; 26(3): 356–62

    Article  PubMed  CAS  Google Scholar 

  28. Walters JA, Wood-Baker R, Walters EH. Long-acting beta2-agonists in asthma: an overview of Cochrane systematic reviews. Respir Med 2005; 99(4): 384–95

    Article  PubMed  CAS  Google Scholar 

  29. Salpeter S, Buckley N, Ormiston T, et al. Meta-analysis: effect of long-acting β-agonists on severe asthma exacerbations and asthma related deaths. Ann Intern Med 2006; 144: 904–12

    PubMed  CAS  Google Scholar 

  30. Beasley R, Pearce N, Crane J, et al. Beta-agonists: what is the evidence that their use increases the risk of asthma morbidity and mortality? J Allergy Clin Immunol 1999; 104 (2 Pt 2): S18–30

    Article  PubMed  CAS  Google Scholar 

  31. Newnham D. Asthma medications and their potential adverse effects in the elderly: recommendations for prescribing. Drug Safety 2001; 24: 1065–80

    Article  PubMed  CAS  Google Scholar 

  32. Burgess C, D’Arcy C, Holman J. Adverse drug reactions in older Australians, 1981–2002. Med J Aust 2005; 182: 267–70

    PubMed  Google Scholar 

  33. Clark N, Jones P, Keller S, et al. Patient factors and compliance with asthma therapy. Respir Med 1999; 93: 856–62

    Article  PubMed  CAS  Google Scholar 

  34. Gibson P, Powell H, Coughlan J, et al. Limited (information only) patient education programs for adults with asthma. Cochrane Database Syst Rev 2002; (2): CD001005

  35. Douglass J, Aroni R, Goeman D, et al. A qualitative study of action plans for asthma. BMJ 2002; 324: 1003–7

    Article  PubMed  Google Scholar 

  36. Jones A, Pill R, Adams S. Qualitative study of views of health professionals and patients on guided self-management plans for asthma. BMJ 2000; 321: 1507–10

    Article  PubMed  CAS  Google Scholar 

  37. Radecki S, Cowell W. Health promotion for elderly patients. Fam Med 1990; 22(4): 299–302

    PubMed  CAS  Google Scholar 

  38. Abramson M, Bailey M, Couper F, et al. Are asthma medications and management related to deaths from asthma? Am J Resp Crit Care Med 2001; 163: 12–8

    PubMed  CAS  Google Scholar 

  39. Ruffin R, Wilson D, Smith B, et al. Prevalence, morbidity and management of adult asthma in South Australia. Immunol Cell Biol 2001; 79: 191–4

    Article  PubMed  CAS  Google Scholar 

  40. Diette G, Krishnan J, Dominici F, et al. Asthma in older patients: factors associated with hospitalisation. Arch Intern Med 2002; 162: 1123–32

    Article  PubMed  Google Scholar 

  41. Adams R, Smith B, Ruffin R. Factors associated with hospital admissions and repeat emergency department visits for adults with asthma. Thorax 2000; 55: 566–73

    Article  PubMed  CAS  Google Scholar 

  42. Australian Bureau of Statistics (ABS) 2004–05 National Health Survey: Australian social trends 2006. ABS cat. no. 4102.0. Canberra (ACT): ABS, 2006

    Google Scholar 

  43. Australian Institute of health and Welfare (AIHW). Australia’s health 2002. AIHW cat. no. AUS25. Canberra (ACT): AIHW, 2002

    Google Scholar 

  44. Paltiel AD, Fuhlbrigge AL, Kitch BT, et al. Cost-effectiveness of inhaled corticosteroids in adults with mild-to-moderate asthma: results from the Asthma Policy Model. J Allergy Clin Immunol 2001; 108(1): 39–46

    Article  PubMed  CAS  Google Scholar 

  45. Schmier J, Halpern M, Jones M. Effects of inhaled corticosteroids on mortality and hospitalisation in elderly asthma and chronic obstructive pulmonary disease. Drugs Aging 2005; 22: 717–29

    Article  PubMed  CAS  Google Scholar 

  46. Goeman D, Hogan C, Aroni R, et al. Barriers to delivering asthma care: a qualitative study of general practitioners. Med J Aust 2005; 183: 457–60

    PubMed  Google Scholar 

  47. Douglass J, Goeman D, Yu E. Asthma 3+ Visit Plan: a qualitative evaluation. Intern Med J 2005; 35: 457–62

    Article  PubMed  CAS  Google Scholar 

  48. Armour C, Bosnic-Anticevich S, Saini B, et al. Pharmacists improving health care for asthma [abstract no. 120]. Proceedings of TSANZ 2006 Annual Scientific Meeting; 2006 Mar 24–29; Canberra (ACT)

  49. Janson S, Hardie G, Fahy J, et al. Use of biological markers of airway inflammation to detect the efficacy of nurse-delivered asthma education. Heart Lung 2001; 30: 39–46

    Article  PubMed  CAS  Google Scholar 

  50. Centers for Disease Control and Prevention (CDC). Asthma mortality and hospitalization among children and young adults — United States, 1980–1993. MMWR Morb Mortal Wkly Rep 1996; 45: 350–3

    Google Scholar 

  51. Johnston S. Overview of virus-induced airway disease. Proc Am Thorac Soc 2005; 2: 150–6

    Article  PubMed  CAS  Google Scholar 

  52. Reddel H, Ware S, Marks G, et al. Differences between asthma exacerbations and poor asthma control. Lancet 1999 Jan 30; 353(9150): 364–9

    Article  PubMed  CAS  Google Scholar 

  53. Robertson C, Rubinfeld A, Bowes G. Deaths from asthma in Victoria: a 12-month survey. Med J Aust 1990; 152: 511–7

    PubMed  CAS  Google Scholar 

  54. Krishnan JA, Riekert KA, McCoy JV, et al. Corticosteroid use after hospital discharge among high-risk adults with asthma. Am J Respir Crit Care Med 2004; 170: 1281–5

    Article  PubMed  Google Scholar 

  55. Biais L, Ernst P, Boivin JF, et al. Inhaled corticosteroids and the prevention of readmission to hospital for asthma. Am J Respir Crit Care Med 1998; 158(1): 126–32

    Google Scholar 

  56. Hartert T, Togias A, Meilen B, et al. Under utilisation of controller and rescue medication among older adults with asthma requiring hospital care. J Am Geriatr Soc 2000; 48: 651–7

    PubMed  CAS  Google Scholar 

  57. Apter A, Boston R, George M, et al. Modifiable barriers to adherence to inhaled steroids among adults with asthma: it’s not just black and white. J Allergy Clin Immunol 2003; 111: 1219–26

    Article  PubMed  Google Scholar 

  58. Weinstein A. Should patients with persistent severe asthma be monitored for medication adherence? Ann Allergy Asthma Immunol 2005; 94: 251–7

    Article  PubMed  Google Scholar 

  59. van Eijken M, Tsang S, Wensing M, et al. Interventions to improve medication compliance in older patients living in the community: a systematic review of the literature. Drugs Aging 2003; 20: 229–40

    Article  PubMed  Google Scholar 

  60. Chapman KR, Walker L, Cluley S, et al. Improving patient compliance with asthma therapy. Respir Med 2000; 94: 2–9

    Article  PubMed  CAS  Google Scholar 

  61. Hippocrates. Decorum, c. 200BC. Quoted in: Sawyer S. Adherence: whose responsibility? In: A decade of coordinated asthma management in Australia. Melbourne (VIC): National Asthma Campaign, 1998: 9–10

  62. Cockburn J. Patient education and strategies to improve adherence. In: Wall R, Jenkins C, editors. Understanding asthma. Sydney (NSW): Maclennan & Petty, 2000

    Google Scholar 

  63. MacLaughlin EJ, Raehl CL, Treadway AK, et al. Assessing medication adherence in the elderly: which tools to use in clinical practice? Drugs Aging 2005; 22: 231–55

    Article  PubMed  Google Scholar 

  64. National Asthma Campaign Ltd (NAC). Asthma adherence: a guide for health professionals. South Melbourne (VIC): NAC Ltd, 1999

    Google Scholar 

  65. Haynes RB, McDonald H, Garg AX, et al. Interventions for helping patients to follow prescriptions for medications. Coch-rane Database Syst Rev 2002; (2): CD000011

  66. Spector S. Noncompliance with asthma therapy: are there solutions? J Asthma 2000; 37: 381–8

    Article  PubMed  CAS  Google Scholar 

  67. Ferner RE. Is concordance the primrose path to health? BMJ 2003; 327: 821–2

    Article  PubMed  Google Scholar 

  68. Higgins N, Regan C. A systematic review of the effectiveness of interventions to help older people adhere to medication regimes. Age Ageing 2004; 44: 224–9

    Article  Google Scholar 

  69. Delado P. Approaches to the enhancement of patient adherence to antidepressant medication treatment. J Clin Psychiatry 2000; 61: 6–9

    Google Scholar 

  70. Allen S. Competence thresholds for the use of inhalers in people with dementia. Age Ageing 1997; 26: 83–6

    Article  PubMed  CAS  Google Scholar 

  71. Basheti I, Reddel H, Armour C, et al. Counseling about turbuhaler technique: needs assessment and effective strategies for community pharmacists. Respir Care 2005; 50: 617–23

    PubMed  Google Scholar 

  72. Allen S, Prior A. What determines whether an elderly patient can use a metered dose inhaler correctly? Br J Dis Chest 1986; 80: 45–9

    Article  PubMed  CAS  Google Scholar 

  73. Allen S, Harries D. Which inhaler for the elderly asthmatic? Geriatr Med 1989; 19: 61–3

    Google Scholar 

  74. Irwin R, Richardson ND. Side effects with inhaled corticosteroids: the physician’s perception. Chest 2006; 130 (1 Suppl.): S41–53

    Article  CAS  Google Scholar 

  75. Ullah M, Newman G. Influence of age on response to ipratropium and salbutamol in asthma. Thorax 1981; 36: 523–9

    Article  PubMed  CAS  Google Scholar 

  76. Piette J, Heisler M, Krein S, et al. The role of patient-physician trust in moderating medication nonadherence due to cost pressures. Arch Intern Med 2005; 165: 1749–55

    Article  PubMed  Google Scholar 

  77. Goeman D, Aroni R, Stewart K, et al. Patients’ views of the burden of asthma: a qualitative study. Med J Aust 2002; 177: 295–9

    PubMed  Google Scholar 

  78. Adams S, Pill R, Jones A, et al. Medication, chronic illness and identity: the perspective of people with asthma. Soc Sci Med 1997; 45: 189–201

    Article  PubMed  CAS  Google Scholar 

  79. Conrad P. The meaning of medications: another look at compliance. Soc Sci Med 1985; 20: 29–37

    Article  PubMed  CAS  Google Scholar 

  80. Britten N. Does a prescribed treatment match a patient’s priorities? BMJ 2003; 327: 840

    Article  PubMed  Google Scholar 

  81. Byer B, Myers L. Psychological correlates of adherence to medication in asthma. Psychol Health Med 2000; 5: 389–93

    Article  Google Scholar 

  82. Wroe AL. Intentional and unintentional non-adherence: a study of decision making. J Behav Med 2002; 25(4): 355–72

    Article  PubMed  Google Scholar 

  83. Bender BG. Overcoming barriers to non-adherence in asthma treatment. J Allergy Clin Immunol 2002; 109 (6 Suppl.): S554–9

    Article  PubMed  Google Scholar 

  84. Sin D, Tu J. Under use of inhaled steroid therapy in elderly patients with asthma. Chest 2001; 119: 720–5

    Article  PubMed  CAS  Google Scholar 

  85. Barr G, Somers S, Speizer F, et al. Patient factors and medication guideline adherence among older women with asthma. Arch Intern Med 2002; 162: 1761–8

    Article  PubMed  Google Scholar 

  86. Osman LM. How do patients’ views about medication affect their self-management in asthma? Patient Educ Couns 1997; 32 (1 Suppl.): S43–9

    Article  PubMed  CAS  Google Scholar 

  87. Horne R. Compliance, adherence, and concordance: implications for asthma treatment. Chest 2006; 130 (1 Suppl.): 65S–72S

    Article  PubMed  Google Scholar 

  88. Donovan J, Blake D. Patient non-compliance: deviance or reasoned decision-making? Soc Sci Med 1992; 34: 507–13

    Article  PubMed  CAS  Google Scholar 

  89. van Schayck CP, Bijl-Hofland ID, Folgering H, et al. Influence of two different inhalation devices on therapy compliance in asthmatic patients. Scand J Prim Health Care 2002; 20: 126–8

    Article  PubMed  Google Scholar 

  90. Pedersen S. Inhalers and nebulisers: which to choose and why. Respir Med 1996; 90: 69–77

    Article  PubMed  CAS  Google Scholar 

  91. Allen SC, Ragab S. Ability to learn inhaler technique in relation to cognitive scores and tests of praxis in old age. Postgrad Med 2002; 78: 37–9

    Article  CAS  Google Scholar 

  92. Stevens D, Sharma L, Kesten S. Insurance status and patient behavior with asthma medications. J Asthma 2003; 40: 789–93

    Article  PubMed  Google Scholar 

  93. Home R, Weinman J, Hankins M. The Beliefs about Medicines Questionnaire (BMQ): the development and evaluation of a new method for assessing the cognitive representation of medication. Psychol Health 1998; 14: 1–24

    Google Scholar 

  94. Jessop D, Rutter D. Adherence to asthma medications: the role of illness representations. Psychol Health 2003; 18: 595–612

    Article  Google Scholar 

  95. Home R, Weinman J. Patients’ beliefs about prescribed medicines and their role in adherence to treatment in chronic physical illness. J Psychosom Res 1999; 47: 555–67

    Article  Google Scholar 

  96. Home R, Weinman J. Self-regulation and self management in asthma: exploring the role of illness perceptions and treatment beliefs in explaining non adherence to preventer medication. Psychol Health 2002; 17: 17–32

    Article  Google Scholar 

  97. Jones GK, Bell J, Fehrenbach C, et al. Understanding patient perceptions of asthma: results of the Asthma Control and Expectations (ACE) survey. Int J Clin Pract 2002; 56: 89–93

    PubMed  Google Scholar 

  98. Jenkins L, Britten N, Stevenson F, et al. Developing and using quantitative instruments for measuring doctor-patient communication about drugs. Patient Educ Couns 2003; 50: 273–8

    Article  PubMed  Google Scholar 

  99. Hand CH, Bradley C. Health beliefs of adults with asthma: toward an understanding of the difference between symptomatic and preventive use of inhaler treatment. J Asthma 1996; 33: 331–8

    Article  PubMed  CAS  Google Scholar 

  100. Irwin R, Richardson N. Patient focused care: using the right tools. Chest 2006; 130: 73S–82S

    Article  PubMed  Google Scholar 

  101. Luskin AT. Relationship: the forgotten component. Ann Allergy Asthma Immunol 1998; 81: 519–21

    Article  PubMed  CAS  Google Scholar 

  102. Onyirimba F, Apter AJ, Reisine S, et al. Direct clinician-to-patient feedback discussion of inhaled steroid use: its effect on adherence. Ann Allergy Asthma Immunol 2003; 90: 411–5

    Article  PubMed  Google Scholar 

  103. Fish L, Lung CL. Adherence to asthma therapy. Ann Allergy Asthma Immunol 2001; 86: 24–30

    Article  PubMed  CAS  Google Scholar 

  104. Shiffman R, Freudigman M, Brandt C, et al. A guideline implementation system using handheld computers for office management of asthma: effects on adherence and patient outcomes. Pediatrics 2000; 105: 767–73

    Article  PubMed  CAS  Google Scholar 

  105. Levy ML. Organized care in general practice: structure and evaluation. Respir Med 1997; 91: 578–80

    Article  PubMed  CAS  Google Scholar 

  106. Kolbe J. Asthma education, action plans, psychosocial issues and adherence. Can Respir J 1999; 6: 273–80

    PubMed  CAS  Google Scholar 

  107. Tomlins R, Hope K. Proactive asthma care: the benefits of behavioural change. Aust Fam Physician 2001 Feb; 30(2): 127

    PubMed  CAS  Google Scholar 

  108. Townsend A, Hunt K, Wyke S. Managing multiple morbidity in mid life: a qualitative study of attitudes to drug use. BMJ 2003; 327: 837–40

    Article  PubMed  Google Scholar 

  109. George M, Freedman T, Norfleet A, et al. Qualitative research-enhanced understanding of patients’ beliefs: results of focus groups with low income, urban, African American adults with asthma. J Allergy Clin Immunol 2003; 111: 967–73

    Article  PubMed  Google Scholar 

  110. Schmaling KB, Afari N, Blume A, et al. Assessment of psychological factors associated with adherence to medication regimens among adult patients with asthma. J Asthma 2000; 37: 335–43

    Article  PubMed  CAS  Google Scholar 

  111. Campbell D, Yellowlees P, McLennan G, et al. Psychiatric and medical features of near fatal asthma. Thorax 1995; 50: 254–9

    Article  PubMed  CAS  Google Scholar 

  112. Harrison B. Psychosocial aspects of asthma in adults. Thorax 1998; 53: 519–25

    Article  PubMed  CAS  Google Scholar 

  113. Harrison B. Difficult asthma in adults: recognition and approaches to management. Intern Med J 2005; 35: 543–7

    Article  PubMed  CAS  Google Scholar 

  114. Bender B, Milgrom H, Apter A, et al. Adherence intervention research: what have we learned and what do we do next? J Allergy Clin Immunol 2003; 112: 489–94

    Article  PubMed  Google Scholar 

  115. Elwyn G, Edwards A, Britten N, et al. Doing prescribing: how doctors can be more effective. BMJ 2003; 327: 846–7

    Article  Google Scholar 

  116. Stevenson F, Gerrett D, Rivers P, et al. GPs’ recognition of and response to influences on patients’ medicine taking: the implications for communication. Fam Pract 2000; 17: 119–23

    Article  PubMed  CAS  Google Scholar 

  117. Bissell P, May C, Noyce P, et al. From compliance to concordance: barriers to accomplishing a re-framed model of health care interactions. Soc Sci Med 2004; 58: 851–62

    Article  PubMed  Google Scholar 

  118. Stevenson F, Scambler G. The relationship between medicine and the public: the challenge of concordance. Health 2005; 9: 5–21

    Article  PubMed  Google Scholar 

  119. Ryan-Woolley BM, Rees JA. Initializing concordance in frail elderly patients via a medicines organizer. Ann Pharmacother 2005; 39: 834–9

    Article  PubMed  Google Scholar 

  120. Jones G. Prescribing and taking medicines. BMJ 2003; 327: 819

    Article  PubMed  Google Scholar 

  121. Benson J, Britten N. What effects do patients feel from their ICS medication and how do they react? Fam Pract 2006; 23: 80–7

    Article  PubMed  Google Scholar 

  122. Pound P, Britten N, Morgan M, et al. Resisting medicines: a synthesis of qualitative studies of medicine taking. Soc Sci Med 2005; 61: 133–55

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

No sources of funding were used to assist in the preparation of this review. Dr Douglass has received travel sponsorship from AstraZeneca, GlaxoSmithKline and Altana Pharma to attend international conferences. The authors have no other potential conflicts of interest that are directly relevant to the content of this review.

Author information

Authors and Affiliations

  1. Co-operative Research Centre for Asthma and Airways, AIRmed, The Alfred Hospital, Commercial Rd, Melbourne, 3004, Australia

    Dianne P. Goeman

  2. Department of Allergy, Immunology and Respiratory Medicine, The Alfred Hospital and Monash University, Melbourne, Victoria, Australia

    Dianne P. Goeman & Jo A. Douglass

Authors
  1. Dianne P. Goeman
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jo A. Douglass
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Dianne P. Goeman.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Goeman, D.P., Douglass, J.A. Optimal Management of Asthma in Elderly Patients. Drugs Aging 24, 381–394 (2007). https://doi.org/10.2165/00002512-200724050-00003

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.2165/00002512-200724050-00003

Keywords

Search

Navigation