Factors influencing therapeutic adherence in Tunisian adults with asthma

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Published Oct 14, 2023
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Vol. 101 No. 6 (2023): Tunis med jun 2023

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Meriem Mjid
LR12SP08, Department of pneumo-allergology , Rabta Hospital, Tunis/ Faculty of Medicine of Tunis- University of Tunis El Manar- Tunis- Tunisia
Imen Ayadi
Immunology laboratory, Rabta Hospital, Tunis, Tunisia
Khadija Echi
LR12SP08, Department of pneumo-allergology , Rabta Hospital, Tunis/ Faculty of Medicine of Tunis- University of Tunis El Manar- Tunis- Tunisia
Lilia Laadhar
Immunology laboratory, Rabta Hospital, Tunis, Tunisia
Abir Hedhli
LR12SP08, Department of pneumo-allergology , Rabta Hospital, Tunis/ Faculty of Medicine of Tunis- University of Tunis El Manar- Tunis- Tunisia
Yacine Ouahchi
LR12SP08, Department of pneumo-allergology , Rabta Hospital, Tunis/ Faculty of Medicine of Tunis- University of Tunis El Manar- Tunis- Tunisia
Sana Chikh Rouhou
LR12SP08, Department of pneumo-allergology , Rabta Hospital, Tunis/ Faculty of Medicine of Tunis- University of Tunis El Manar- Tunis- Tunisia
Sonia Toujani
LR12SP08, Department of pneumo-allergology , Rabta Hospital, Tunis/ Faculty of Medicine of Tunis- University of Tunis El Manar- Tunis- Tunisia
Maryam Kallel-Sellami
Immunology laboratory, Rabta Hospital, Tunis, Tunisia
Basma Dhahri
LR12SP08, Department of pneumo-allergology , Rabta Hospital, Tunis/ Faculty of Medicine of Tunis- University of Tunis El Manar- Tunis- Tunisia

Abstract

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. 

Keywords:

asthma, adult, compliance, factors

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