Assessing medication adherence in adults with asthma and its effect on rescue therapy for exacerbations
IntroductionAdherence to prescribed inhaled controller medication is a determinant of asthma health outcomes. Traditional methods for assessing medication adherence (MA) can be challenging in real-world clinical settings. A new behavioral science approach presents opportunities to develop a novel MA...
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Frontiers Media S.A.
2025-03-01
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fphar.2025.1516062/full |
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| author | Yi Ling Eileen Koh Kian Yong Kenny Chua Kian Yong Kenny Chua Ding Xuan Ng Wai Keong Aau Ngiap Chuan Tan Ngiap Chuan Tan |
| author_facet | Yi Ling Eileen Koh Kian Yong Kenny Chua Kian Yong Kenny Chua Ding Xuan Ng Wai Keong Aau Ngiap Chuan Tan Ngiap Chuan Tan |
| author_sort | Yi Ling Eileen Koh |
| collection | DOAJ |
| description | IntroductionAdherence to prescribed inhaled controller medication is a determinant of asthma health outcomes. Traditional methods for assessing medication adherence (MA) can be challenging in real-world clinical settings. A new behavioral science approach presents opportunities to develop a novel MA assessment tool that also allows the prediction of acute asthma exacerbations. The current study aims to evaluate MA among adults with asthma based on their prescription collection behavior and its relationship with subsequent exacerbations.MethodThis retrospective study was conducted on Asian adults with clinically diagnosed asthma and managed in public primary care clinics in Singapore from 2016 to 2023. Clinical data of patients, including socio-demographical, clinical (including Asthma Control Test scores), and prescription records were thoroughly examined to determine MA. The participants were stratified into the Full Collection (FC) group for those collections of prescribed asthma medication within a week; Partial Collection (PC) group for partial medication collection; No Collection (NC) group for no dispensation record within 1 year of the prescription date. The Proportion of Days Covered (PDC), defined as the proportion of days in which a patient gets access to the medication was determined to correlate with the prescription collection method. Multiple stepwise logistic regression was used to assess MA with rescue therapy (RT) occurrence as indicators of acute asthma exacerbations.ResultsIn this study, complete records of 13,482 patients were analyzed. The patients were categorized into three groups: FC (23.2%), PC (72.9%), and NC (3.9%) groups. Those who had PC or NC were more likely to have RT in the following year (19.5% and 9.4%, respectively), compared to FC (5.2%) group. Patients with RT demonstrated higher oral steroid dispensed compared to those without RT (mean (SD) of 319.7 (273.7) vs. 143.6 (175.8) compared to patients without RT (0.78 [0.26] vs. 0.81 [0.29]). Logistic regression analysis revealed that both patients from PC and NC groups had a greater probability of experiencing RT in the following year (partial: 2.364 (1.964–2.847), p < 0.001); no collection: 2.030 (1.318–3.127), p = 0.001). Lower minimum ACT scores (0.317 vs. 1.0) were noted for the PC group and an increase in minimal ACT score of 0.167 for every unit increase in PDC was also observed.ConclusionPatients in the FC group exhibited higher MA and were less likely to receive RT due to their asthma exacerbations in subsequent years. |
| format | Article |
| id | doaj-art-80f4e0999b6340abb8ae5887175efcce |
| institution | DOAJ |
| issn | 1663-9812 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Frontiers Media S.A. |
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| spelling | doaj-art-80f4e0999b6340abb8ae5887175efcce2025-08-20T02:46:28ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122025-03-011610.3389/fphar.2025.15160621516062Assessing medication adherence in adults with asthma and its effect on rescue therapy for exacerbationsYi Ling Eileen Koh0Kian Yong Kenny Chua1Kian Yong Kenny Chua2Ding Xuan Ng3Wai Keong Aau4Ngiap Chuan Tan5Ngiap Chuan Tan6SingHealth Polyclinics, Research, Singapore, SingaporeNational University of Singapore, Institute of System Science, Singapore, SingaporeDefence Science and Technology Agency, Building and Infrastructure, Singapore, SingaporeSingHealth Polyclinics, Research, Singapore, SingaporeSingHealth Polyclinics, Research, Singapore, SingaporeSingHealth Polyclinics, Research, Singapore, SingaporeSingHealth-Duke NUS, Family Medicine Academic Clinical Program, Singapore, SingaporeIntroductionAdherence to prescribed inhaled controller medication is a determinant of asthma health outcomes. Traditional methods for assessing medication adherence (MA) can be challenging in real-world clinical settings. A new behavioral science approach presents opportunities to develop a novel MA assessment tool that also allows the prediction of acute asthma exacerbations. The current study aims to evaluate MA among adults with asthma based on their prescription collection behavior and its relationship with subsequent exacerbations.MethodThis retrospective study was conducted on Asian adults with clinically diagnosed asthma and managed in public primary care clinics in Singapore from 2016 to 2023. Clinical data of patients, including socio-demographical, clinical (including Asthma Control Test scores), and prescription records were thoroughly examined to determine MA. The participants were stratified into the Full Collection (FC) group for those collections of prescribed asthma medication within a week; Partial Collection (PC) group for partial medication collection; No Collection (NC) group for no dispensation record within 1 year of the prescription date. The Proportion of Days Covered (PDC), defined as the proportion of days in which a patient gets access to the medication was determined to correlate with the prescription collection method. Multiple stepwise logistic regression was used to assess MA with rescue therapy (RT) occurrence as indicators of acute asthma exacerbations.ResultsIn this study, complete records of 13,482 patients were analyzed. The patients were categorized into three groups: FC (23.2%), PC (72.9%), and NC (3.9%) groups. Those who had PC or NC were more likely to have RT in the following year (19.5% and 9.4%, respectively), compared to FC (5.2%) group. Patients with RT demonstrated higher oral steroid dispensed compared to those without RT (mean (SD) of 319.7 (273.7) vs. 143.6 (175.8) compared to patients without RT (0.78 [0.26] vs. 0.81 [0.29]). Logistic regression analysis revealed that both patients from PC and NC groups had a greater probability of experiencing RT in the following year (partial: 2.364 (1.964–2.847), p < 0.001); no collection: 2.030 (1.318–3.127), p = 0.001). Lower minimum ACT scores (0.317 vs. 1.0) were noted for the PC group and an increase in minimal ACT score of 0.167 for every unit increase in PDC was also observed.ConclusionPatients in the FC group exhibited higher MA and were less likely to receive RT due to their asthma exacerbations in subsequent years.https://www.frontiersin.org/articles/10.3389/fphar.2025.1516062/fullrescue therapyAsthma Control testproportion of days coveredinhalersprimary care |
| spellingShingle | Yi Ling Eileen Koh Kian Yong Kenny Chua Kian Yong Kenny Chua Ding Xuan Ng Wai Keong Aau Ngiap Chuan Tan Ngiap Chuan Tan Assessing medication adherence in adults with asthma and its effect on rescue therapy for exacerbations Frontiers in Pharmacology rescue therapy Asthma Control test proportion of days covered inhalers primary care |
| title | Assessing medication adherence in adults with asthma and its effect on rescue therapy for exacerbations |
| title_full | Assessing medication adherence in adults with asthma and its effect on rescue therapy for exacerbations |
| title_fullStr | Assessing medication adherence in adults with asthma and its effect on rescue therapy for exacerbations |
| title_full_unstemmed | Assessing medication adherence in adults with asthma and its effect on rescue therapy for exacerbations |
| title_short | Assessing medication adherence in adults with asthma and its effect on rescue therapy for exacerbations |
| title_sort | assessing medication adherence in adults with asthma and its effect on rescue therapy for exacerbations |
| topic | rescue therapy Asthma Control test proportion of days covered inhalers primary care |
| url | https://www.frontiersin.org/articles/10.3389/fphar.2025.1516062/full |
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