Adherence to therapy in adult patients with bronchial asthma

Background: The global prevalence of bronchial asthma according to the WHO is 235 million and adherence to therapy is now becoming one of the main issues in its effective management all over the world. In developing countries such as India, easy accessibility to drugs and inadequate health services results in increased use of self-medication. Over-the-counter drugs though meant of self-medication, their inappropriate use can be potentially hazardous, and there is always a risk of interaction with other prescription drugs. Very few studies have been published regarding self-medication pattern in India and hardly any studies regarding their interactions with prescription drugs in asthma, hence this study was proposed. Methods: One hundred adult ambulatory patients aged above 20 years were randomly selected from the respiratory outpatient department of a tertiary care government teaching hospital in Pune. The participants were subjected to a semi-structured interview with the help of a questionnaire. Results: Ninety-one percent were adherent to therapy. The main reasons for not adhering to therapy as suggested by the questionnaire and interview were old age and difficulty in using the inhaled medications appropriately. Self-medication was in 16% of the patients and the most common drugs being proton-pump inhibitors, H2 blockers, and antihistaminics, but no significant interaction was observed. Conclusions: In our study, the adherence was well above the global figures. Nonadherence to therapy is estimated to be 50% for chronic illnesses. A multidimensional approach by proper management and increasing interaction time with the patients will go a long way in improving the management of such conditions. Elderly people should be specially targeted as they have multifactorial reasons for not adhering to therapy. Effective but simple and uncomplicated regimens, convenient dosing and route of administration, less expensive, and safer drugs should be the aim in the treatment of bronchial asthma.