Factors Influencing Adherence to The Use of Inhalers for Control of Asthma in Adult Out-Patients in a Nigerian Teaching Hospital

Abstract

Asthma remains a poorly controlled disease despite the availability of new management guidelines and effective medications leading to increasing morbidity and mortality. The objective of this study was to determine the factors that influence adherence to the use of inhalers for the control of asthma in adult asthmatics. The study was a cross-sectional analytical conducted over a year from the first of June 2010 at the Medical Outpatient Clinic of University College Hospital Ibadan. The study population was composed of 355 randomly selected adults aged between 18years and 55years with an established diagnosis of asthma already on treatment and follow up. Chi-square test was used for bivariate analyses to test the significance of the association between categorical variables and asthma control and adherence to drugs. Logistic regression analysis was performed for the various factors to show the predictors of asthma control and adherence to treatment. There were 188 females (53%) and 167males (47%). The mean age of the consenting patients was 39.04 years (SD± 11.335). Patients with correct inhaler technique had good asthma control (72.9%) compared to those with incorrect inhaler technique (61.9%), (p=0.085). Patients who used metered dose inhalers(MDI) and dry powder inhalers (DPI) had good asthma control (83.7%) compared to those who used MDI (62.9%) alone and DPI (57.7%) alone, (p=0.001). This study showed that a high proportion of patients on both MDI and DPI had better control of asthma than those on either DPI or MDI alone. And that the predictor of good asthma control was inhaler preference.