Associations between medication and disease beliefs and use of inhaled corticosteroids among inner city adults with persistent asthma

This study examined underlying beliefs that may explain suboptimal adherence with inhaled corticosteroid (ICS) among inner city adults with moderate and severe asthma. A prospective cohort of consecutive adults hospitalized at a large New York City hospital over 1 year were interviewed at baseline a...

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Published in:Journal of allergy and clinical immunology 2004-02, Vol.113 (2), p.S261-S261
Main Authors: Halm, E.A., Cooperman, A., Leventhal, H.
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Cooperman, A.
Leventhal, H.
description This study examined underlying beliefs that may explain suboptimal adherence with inhaled corticosteroid (ICS) among inner city adults with moderate and severe asthma. A prospective cohort of consecutive adults hospitalized at a large New York City hospital over 1 year were interviewed at baseline and 6 months to assess medication and disease beliefs and self-reported ICS adherence. Overall, 204/218 patients (Pts) consented and 97% and 84% completed baseline and 6 month interviews(28% in Spanish). Mean age was 49.9 years, 78% female, 62% Hispanic, 28% African-American, and 5% White. Twenty-three percent had previous intubations and 88% prior steroids. Before hospitalization, 66% were on ICS. Of these, 73% used them regularly when symptomatic vs. 58% when asymptomatic (p
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A prospective cohort of consecutive adults hospitalized at a large New York City hospital over 1 year were interviewed at baseline and 6 months to assess medication and disease beliefs and self-reported ICS adherence. Overall, 204/218 patients (Pts) consented and 97% and 84% completed baseline and 6 month interviews(28% in Spanish). Mean age was 49.9 years, 78% female, 62% Hispanic, 28% African-American, and 5% White. Twenty-three percent had previous intubations and 88% prior steroids. Before hospitalization, 66% were on ICS. Of these, 73% used them regularly when symptomatic vs. 58% when asymptomatic (p<.02). At 6 months, ICS prescriptions increased to 76% (p<.04), though use when symptomatic (77%) and asymptomatic (64%) was unchanged. Eighty-five percent said it was very important to use ICS when symptomatic compared to 65% important to use when asymptomatic (p<.05). Fifty-seven percent worried about side effects and 45% worried about addiction to ICS. Beliefs about importance of using ICS when symptomatic correlated most strongly with ICS use when symptomatic (r=.82; p<.0001) and beliefs about the importance of using ICS when asymptomatic correlated most strongly with ICS when asymptomatic (r=.88; p<.0001). Concerns about side effects and addiction were not significantly correlated with adherence. Beliefs about having asthma even when they did not have symptoms correlated with adherence (r=.28; p<.001), but beliefs about underlying lung inflammation were not Efforts to improve asthma outcomes should concentrate on addressing suboptimal medication and disease beliefs.]]></description><identifier>ISSN: 0091-6749</identifier><identifier>EISSN: 1097-6825</identifier><identifier>DOI: 10.1016/j.jaci.2004.01.408</identifier><language>eng</language><publisher>St. Louis: Mosby, Inc</publisher><ispartof>Journal of allergy and clinical immunology, 2004-02, Vol.113 (2), p.S261-S261</ispartof><rights>2004</rights><rights>Copyright Elsevier Limited Feb 2004</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,777,781,27905,27906</link.rule.ids></links><search><creatorcontrib>Halm, E.A.</creatorcontrib><creatorcontrib>Cooperman, A.</creatorcontrib><creatorcontrib>Leventhal, H.</creatorcontrib><title>Associations between medication and disease beliefs and use of inhaled corticosteroids among inner city adults with persistent asthma</title><title>Journal of allergy and clinical immunology</title><description><![CDATA[This study examined underlying beliefs that may explain suboptimal adherence with inhaled corticosteroid (ICS) among inner city adults with moderate and severe asthma. 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title Associations between medication and disease beliefs and use of inhaled corticosteroids among inner city adults with persistent asthma
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