Factors influencing therapeutic adherence in Tunisian adults with asthma


Meriem Mjid
Imen Ayadi
Khadija Echi
Lilia Laadhar
Abir Hedhli
Yacine Ouahchi
Sana Chikh Rouhou
Sonia Toujani
Maryam Kallel-Sellami
Basma Dhahri


Introduction: Despite current recommendations, most asthmatics remain insufficiently controlled. This is largely due to non-adherence to medications. Looking for factors associated with lack of therapeutic adherence is mandatory in order to improve the management of these patients.

Aim:  To assess the degree of compliance in a population of Tunisian asthmatic patients and to identify the factors associated with poor compliance.

Methods: It was a cross-sectional study over a period of six months. Asthma control was assessed using the Asthma Control Test. Treatment compliance was specified using the Morisky questionnaire. Associations between adherence to treatment and certain patient characteristics were sought.

Results: 165 adult patients were included (average age: 46.8 years±15.3 years; 114 women). The median duration of asthma evolution was 10.5 years [1-60 years]. Asthma was uncontrolled in 50% of the cases. Lack of treatment adherence was observed in 45% of patients. Compliance was better in women (p <0.05) and in patients with better socioeconomic status (p= 0.04). Patients with gastroesophageal reflux disease were also more observant (p=0.03); however, those with obesity were less (p> 0.05). In multivariate analysis, patients with good socioeconomic conditions (OR=4,516 ; IC95% [1.433-14.232] ; p=0,01) and those with a previous a history of coronary artery disease (OR=15,37 ; IC95% [1.25-188.857] ; p=0.03) were more likely to have good adherence.

Conclusion: Although it is a key element in the management of asthma, treatment compliance remains insufficient in Tunisian patients with asthma. Patient education is essential in order to correct the factors incriminated in uncontrolled asthma. 


asthma, adult, compliance, factors



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