Adherence to medication among adult asthma patients in the Middle East and North Africa: results from the ESMAA study.
Administration, Inhalation
Adult
Africa, Northern
/ epidemiology
Asthma
/ drug therapy
Cross-Sectional Studies
Drug Therapy, Combination
Health Education
Humans
Medication Adherence
/ statistics & numerical data
Middle Aged
Middle East
/ epidemiology
Quality of Life
Severity of Illness Index
Social Class
Surveys and Questionnaires
Adherence
Asthma control
ESMAA
MMAS-4 ©
Middle east
North africa
Journal
Respiratory medicine
ISSN: 1532-3064
Titre abrégé: Respir Med
Pays: England
ID NLM: 8908438
Informations de publication
Date de publication:
01 2021
01 2021
Historique:
received:
24
09
2020
revised:
15
11
2020
accepted:
17
11
2020
pubmed:
1
12
2020
medline:
29
10
2021
entrez:
30
11
2020
Statut:
ppublish
Résumé
Low levels of adherence to asthma medication is reported in many countries worldwide. Improved knowledge of adherence in the Middle East and North Africa (MENA) is needed to address this major public healthcare burden. Assess the level of adherence in patients attending a routine consultation and the relationship between adherence, patient/disease characteristics, disease control, and quality of life. A large-scale cross-sectional epidemiological study was performed on adults suffering from asthma for at least 1 year and without an acute asthma episode within 4 weeks. Adherence was assessed using the MMAS-4 questionnaire©. Predictive factors of adherence were analyzed with logistic regressions. Overall 7203 eligible patients were included in 577 sites. Mean age was 45.4 years (±14.7), 57.2% were female, mean BMI was 28.5 kg/m2 (±6.0), and 11% were active smokers. Good adherence was observed in 23.6% with a country effect (p < 0.001). Higher age, higher SF-8 Mental component score, and high level of control were associated with good adherence (p < 0.001). Patients treated with a fixed combination (ICS + LABA) have better adherence and patients treated with short-acting beta agonist alone have a lower adherence. Good adherence has been noted in 528 uncontrolled patients suggesting the existence of a subgroup difficult to treat and who have severe asthma. Asthma adherence in the MENA is unsatisfactory with less than one quarter of asthma patients having good adherence. This finding highlights the need to improve access to treatment, ensure better control follow-up and improved education among healthcare providers and patients.
Sections du résumé
BACKGROUND
Low levels of adherence to asthma medication is reported in many countries worldwide. Improved knowledge of adherence in the Middle East and North Africa (MENA) is needed to address this major public healthcare burden.
OBJECTIVE
Assess the level of adherence in patients attending a routine consultation and the relationship between adherence, patient/disease characteristics, disease control, and quality of life.
METHODS
A large-scale cross-sectional epidemiological study was performed on adults suffering from asthma for at least 1 year and without an acute asthma episode within 4 weeks. Adherence was assessed using the MMAS-4 questionnaire©. Predictive factors of adherence were analyzed with logistic regressions.
RESULTS
Overall 7203 eligible patients were included in 577 sites. Mean age was 45.4 years (±14.7), 57.2% were female, mean BMI was 28.5 kg/m2 (±6.0), and 11% were active smokers. Good adherence was observed in 23.6% with a country effect (p < 0.001). Higher age, higher SF-8 Mental component score, and high level of control were associated with good adherence (p < 0.001). Patients treated with a fixed combination (ICS + LABA) have better adherence and patients treated with short-acting beta agonist alone have a lower adherence. Good adherence has been noted in 528 uncontrolled patients suggesting the existence of a subgroup difficult to treat and who have severe asthma.
CONCLUSIONS
Asthma adherence in the MENA is unsatisfactory with less than one quarter of asthma patients having good adherence. This finding highlights the need to improve access to treatment, ensure better control follow-up and improved education among healthcare providers and patients.
Identifiants
pubmed: 33253971
pii: S0954-6111(20)30384-X
doi: 10.1016/j.rmed.2020.106244
pii:
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
106244Informations de copyright
Copyright © 2020 Elsevier Ltd. All rights reserved.