Impact of an Adherence Intervention Program on Medication Adherence Barriers, Asthma Control, and Productivity/Daily Activities in Patients With Asthma

Abstract

Objective. This study evaluated the impact of an asthma patient intervention program, with a focus on medication adherence on adherence barriers, asthma control, and productivity/daily activities. Methods. Patients ≥18 years old who were employed by a large Southeastern public school system, had ≥1 medical claim for asthma, and were taking ≥1 asthma medication were invited to participate in the study. The ASK-20, the Asthma Control Test (ACT), and a productivity questionnaire were administered before and after a 6-month period of intervention that involved the use of baseline ASK-20 results to create patient-specific reports on adherence barriers and talking points for care managers to use during the two outbound telephone calls addressing barriers identified. Patients also received three educational mailings. The ASK-20 is a brief, self-reported instrument developed to identify patient-specific barriers to medication adherence and to improve provider/patient communication about adherence. Results. Of 112 individuals who enrolled, 87 completed the program (77.7%). Participants' mean age was 48.2 years (SD = 10.5), and most were female (86.2%) and white (64.4%). The mean number of years with asthma was 17.5 (SD = 14.7); approximately one third (36.8%) of participants had had asthma for >20 years. The intervention was associated with a significant reduction in the number of adherence barriers (3.8 to 2.8; p = .0021) as well as improvement in asthma control as reflected in an increase in the percentage of participants with controlled asthma defined as having an ACT score > 19 (50.0% to 64.6%; p = .0285). Significant reductions in the mean number of days that housework or schoolwork was limited by asthma (p = .0059) and the mean number of days that family, social, or recreational activities were missed or limited because of asthma (p = .0185) were also observed. The majority of the participants (95%) rated the program as being good, very good, or excellent. Conclusion. Programs incorporating a clinical assessment tool such as the ASK-20 for identifying a broad range of risk factors for nonadherence and for developing patient-specific intervention may reduce adherence barriers and improved disease control and ability to perform daily activities in patients with asthma.

• adherence intervention
• asthma
• barriers
• medication adherence

Acknowledgments

GlaxoSmithKline funded this study.

Declaration of Interest

Authors Park and Skinner are employees of GlaxoSmithKline. James Jackson is employed by Xcenda, which received funding from GlaxoSmithKline to conduct the study. Jane Saiers' assistance with writing the manuscript was funded by GlaxoSmithKline. Karlene Ranghell and Becky Cherney are employed by FHCC, which received funding from GlaxoSmithKline to coordinate the study.