Asthma inhaler adherence determinants in adults

systematic review of observational data

Alexandra L Dima, Gimena Hernandez, Oriol Cunillera, Montserrat Ferrer, Marijn de Bruin, the ASTRO-LAB group

Research output: Contribution to journalArticle

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Abstract

Nonadherence to inhaled medication leads to poor asthma control and increased healthcare utilisation. Many studies exploring adherence determinants have been conducted, but summaries of the evidence are scarce. We performed a systematic review of observational research on determinants of asthma inhaler adherence among adults. We searched for articles in English reporting quantitative observational studies on inhaler adherence correlates among adults in developed countries, published in EMBASE, Medline, PsychInfo and PsychArticles in 1990-2014. Two coders independently assessed eligibility and extracted data, and assessed study quality. Results were summarised qualitatively into social and economic, and healthcare-, therapy-, condition- and patient-related factors. The 51 studies included mainly examined patient-related factors and found consistent links between adherence and stronger inhaler-necessity beliefs, and possibly older age. There was limited evidence on the relevance of other determinants, partly due to study heterogeneity regarding the types of determinants examined. Methodological quality varied considerably and studies performed generally poorly on their definitions of variables and measures, risk of bias, sample size and data analysis. A broader adoption of common methodological standards and health behaviour theories is needed before cumulative science on the determinants of adherence to asthma inhalers among adults can develop further.

Original languageEnglish
Article number01751-2014
Pages (from-to)994-1018
Number of pages25
JournalEuropean Respiratory Journal
Volume45
Issue number4
Early online date10 Dec 2014
DOIs
Publication statusPublished - Jan 2015

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Nebulizers and Vaporizers
Asthma
Delivery of Health Care
Health Behavior
Developed Countries
Sample Size
Observational Studies
Economics
Research
Therapeutics

Cite this

Dima, A. L., Hernandez, G., Cunillera, O., Ferrer, M., de Bruin, M., & the ASTRO-LAB group (2015). Asthma inhaler adherence determinants in adults: systematic review of observational data. European Respiratory Journal, 45(4), 994-1018. [01751-2014]. https://doi.org/10.1183/09031936.00172114

Asthma inhaler adherence determinants in adults : systematic review of observational data. / Dima, Alexandra L; Hernandez, Gimena; Cunillera, Oriol; Ferrer, Montserrat; de Bruin, Marijn; the ASTRO-LAB group.

In: European Respiratory Journal, Vol. 45, No. 4, 01751-2014, 01.2015, p. 994-1018.

Research output: Contribution to journalArticle

Dima, AL, Hernandez, G, Cunillera, O, Ferrer, M, de Bruin, M & the ASTRO-LAB group 2015, 'Asthma inhaler adherence determinants in adults: systematic review of observational data', European Respiratory Journal, vol. 45, no. 4, 01751-2014, pp. 994-1018. https://doi.org/10.1183/09031936.00172114
Dima, Alexandra L ; Hernandez, Gimena ; Cunillera, Oriol ; Ferrer, Montserrat ; de Bruin, Marijn ; the ASTRO-LAB group. / Asthma inhaler adherence determinants in adults : systematic review of observational data. In: European Respiratory Journal. 2015 ; Vol. 45, No. 4. pp. 994-1018.
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