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Volume 18 Issue 4 December 2009

Original Research

The value of self-report assessment of adherence, rhinitis and smoking in relation to asthma control

Pages 300-305
Jane Clatworthya, David Priceb, Dermot Ryanb, John Haughneyb, *Rob Hornea

a Centre for Behavioural Medicine, Department of Practice and Policy, The School of Pharmacy, University of London, BMA House, London, UK

b Department of General Practice and Primary Care, University of Aberdeen, Foresterhill Health Centre, Aberdeen, UK

Received 2 October 2008 • Accepted 19 March 2009 • Online 26 June 2009


Abstract
AIMS: To explore the utility of self-report measures of inhaled corticosteroid (ICS) adherence, degree of rhinitis and smoking status and their association with asthma control. METHODS: Patients prescribed ICS for asthma at 85 UK practices were sent validated questionnaire measures of control (Asthma Control Questionnaire; ACQ) and adherence (Medication Adherence Report Scale), a two-item measure of smoking status, and a single-item measure of rhinitis. RESULTS: Complete anonymised questionnaires were available for 3916 participants. Poor asthma control (ACQ >1.5) was associated with reported rhinitis (OR = 4.62; 95% CI: 3.71-5.77), smoking (OR = 4.33; 95% CI: 3.58-5.23) and low adherence to ICS (OR = 1.35; 95% CI: 1.18-1.55). The degree of rhinitis was important, with those reporting severe rhinitis exhibiting the worst asthma control, followed by those reporting mild rhinitis and then those reporting no rhinitis symptoms (F(2, 3913)=128.7, p<.001). There was a relationship between the number of cigarettes smoked each day and asthma control (F(5,655)=6.08, p<.001). CONCLUSIONS: Poor asthma control is associated with self-reported rhinitis, smoking and low medication adherence. These potentially modifiable predictors of poor asthma control can be identified through a brief self-report questionnaire, used routinely as part of an asthma review.

Cite as: Clatworthy J, Price D, Ryan D, Haughney J, Horne R. The value of self-report assessment of adherence, rhinitis and smoking in relation to asthma control. Prim Care Respir J 2009;18(4):300-305. DOI: http://dx.doi.org/10.4104/pcrj.2009.00037

Keywords
Asthma, control, rhinitis, smoking, compliance, adherence

* Corresponding author. Rob Horne Tel: +44 (0) 20 7874 1293 Fax: +44 (0) 20 7387 5693 Email: rob.horne@pharmacy.ac.uk