Beliefs about medicines and adherence to asthma medications during pregnancy

Abstract

Objective

Discontinuation of, and non-adherence to, inhaled corticosteroids (ICS) for asthma treatment is a significant issue in pregnancy. This study characterized beliefs about medicines in pregnant women with asthma and investigated associations with ICS adherence.

Methods

Pregnant women with relatively mild asthma (n = 302) were grouped according to ICS use and self-reported adherence (≥80% doses taken). They completed questions about dislike of asthma medications and the validated Beliefs about Medicines Questionnaire (BMQ), which consists of ten questions about asthma medicines (“necessity” questions about maintaining health, or “concern” questions about adverse effects), and eight general medicine questions, scored on five-point Likert scales. The Necessity Concerns differential (N-C) was calculated, with positive scores indicating that the patient perceives the benefits of medicines to outweigh the risks.

Results

ICS was used by 87 (29%) women, with 49 (56%) self-reporting adherence. Of the 22% who disliked taking asthma medications during pregnancy, 20% had the belief that the medication was unsafe. ICS users had a significantly higher BMQ necessity score and higher necessity-concern differential score than nonusers; when adjusted for covariates, ICS non-adherence was associated with a lower necessity score (p = 0.015). Women adherent to ICS were more likely to agree to “my health at present depends on my asthma medication” compared to non-adherent ICS users.

Conclusions

ICS non-adherence was not associated with having relatively more concerns about asthma medicines; however, ICS users were more likely to perceive that the benefits of medication use outweighed any risks. Interventions to improve asthma medication adherence in pregnancy are needed.

Keywords:

• Pregnancy
• treatment
• inhaled corticosteroid

Acknowledgements

We thank Kelly Steel and Karen McLaughlin for assistance with data collection, and Heather Powell for project management.

Declaration of interest

The authors have no conflicts of interest to declare in relation to this manuscript.

Disclosure statement

VEM is supported by a Career Development Fellowship from the NHMRC (grant no. APP1084816), the Glady M. Brawn Memorial Career Development Fellowship from the University of Newcastle and the Medical Research Future Fund Investigator Grant (application ID 1196252). PGG reports personal fees from AstraZeneca, GlaxoSmithKline, Novartis, personal fees from Chiesi, Sanofi, grants from AstraZeneca, GlaxoSmithKline, outside the submitted work.

MEJ is supported by a Peggy Lang Hunter Children’s Research Foundation Early Career Fellowship. The authors alone are responsible for the content of this manuscript.

Funding

The MAP study was originally funded by the National Health and Medical Research Council (NHMRC) of Australia.

Data availability statement

The data that support the findings of this study are available from the corresponding author, VEM, upon reasonable request.