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Original Article


Adherence to Treatment: Assessment of an Unmet Need in Asthma


I Baiardini,1 F Braido ,1 A Giardini,2 G Majani,2 C Cacciola ,2 A Rogaku,2 A Scordamaglia,1 GW Canonica1

1 Allergy and Respiratory Diseases, DIMI, Genoa University, Genoa, Italy
2 Servizio di Psicologia, Fondazione S. Maugeri, Clinica del Lavoro e della Riabilitazione IRCCS, Istituto Scientifico di Montescano, Pavia, Italy

J Investig Allergol Clin Immunol 2006; Vol. 16(4): 218-223



Background: In asthma, as in other chronic conditions, poor adherence to treatment and to medical advice is common and contributes to substantial worsening of the disease and increased health care costs.

Objective: The aim of the present study was to evaluate patients’ self-reported adherence to asthma medication regimens and to identify possible correlations between treatment adherence and depression, anxiety, and coping strategies.

Methods: Sixty-three asthmatic outpatients (27 men and 36 women; mean age ± SD, 38.5 ± 14.1) were consecutively enrolled during their routine control visit. Patients were asked to complete 3 different questionnaires: the Adherence Schedule in Asthma, the Hospital Anxiety and Depression Scale, and the Coping Orientations to Problem Experienced questionnaires.

Results: Depression was detected in 32.3% of patients and anxiety in 34.9%. A negative correlation was found between older age and perception of family support (ρ = – 0.33). The presence of anxiety displayed a positive correlation with difficulty in accepting the illness (ρ = 0.33) and a negative correlation with acceptance of illness limitations (ρ = – 0.30); it was also positively correlated with fear of the side effects of medication (ρ = 0.37 . The presence of depression was negatively correlated with acceptance of illness limitations (ρ = – 0.32), knowledge of the illness (ρ = – 0.29), and with ability to identify worsening signs (ρ = – 0.31).

Conclusion: This study shows how different factors may modulate adherence to asthma treatment. The opportunity to identify reasons for nonadherence through a simple assessment will allow a tailored intervention to be planned for each patient.

Key words: Asthma. Adherence. Coping. Depression. Anxiety.