A study conducted by scientists in Northern Ireland has revealed that asthmatics with especially hard-to-treat symptoms who find their medication isn't working adequately to manage their respiratory distress may actually be causing the problems themselves because they aren't following their doctor's order.

In fact, the researchers point out that patient compliance, or lack thereof, is a serious concern that may play a large part in many non-responsive asthma cases.

The Importance of Patient Compliance

Consider this. Until recently, many doctors believed that some patients simply don't respond well to the types of treatment strategies commonly used to treat asthma, such as inhaled and oral corticosteroids. But now, the Northern Ireland study sheds light on the fact that the patients with uncontrolled symptoms may not actually have a more challenging condition than their counterparts or be less responsive to treatment, but instead they may simply be much less diligent about following their treatment plan as directed.

To come to this conclusion, the scientists looked at close to 200 patients being treated for difficult asthma conditions and assessed how well they followed their doctor's orders. To determine such patient compliance, the researchers asked participants about their medication usage, and also looked at the amounts of drugs patients used and how often they received refills. They also conducted blood tests to determine the amount of medication that was in each person's system.

The Findings

Interestingly enough, the results showed that that patient compliance with taking medications was lower than researchers had expected. However, in the majority of cases, patients didn't self disclose their careless usage patterns. It was only after following up on the data that many admitted that they were lax with taking their medications.

The findings, which were published in the American Journal of Respiratory and Critical Care Medicine in the fall of 2009, concluded that as many as a third of patients filled half or less of their prescribed inhaled combination therapy, while close to 50 percent of those using oral cortisteroids for maintenance didn't follow the directions for how to take them correctly. In addition, people who didn't take their oral medication properly were also less likely to use their inhaler consistently.  Similar patient compliance issues and concerns have been found in other studies looking at children and adolescents as well.

The Lesson

If you struggle with difficult asthma, all this information may serve as a warning to remind you to look at your own medication practices and step them up, if needed. For instance, if you find yourself being careless and skipping doses, taking less than the doctor recommends or not monitoring your own symptoms, you should think twice about these habits and take this opportunity to recommit to taking care of yourself and your respiratory system. The good news is that those patients who do take their medication as directed do seem to have much more controlled asthma and their systems are less frequent. Therefore, following your doctor's order just may make you feel better over the long-term.


America Journal of Respiratory and Critical Care Medicine

US National Library of Medicine