August 20, 2014
Practical Advice Helps Asthma Medication Adherence
in Older Adults

New York—How can pharmacists help elderly asthma patients use their medications more regularly? New research offers some very practical answers.

Researchers from the Icahn School of Medicine in New York embarked on the study because of evidence that older adults with asthma have low levels of adherence to their prescribed inhaled corticosteroids (ICS). The study, published recently in the Journal of General Internal Medicine, sought to identify strategies to help those patients achieve daily use of the medications.

Asthma affects up to 9% of Americans older than 65 years, according to the report, which adds that about two of every three asthma-related deaths in the United States occur among people older than 55 years old.

Researchers conducted the Asthma Beliefs and Literacy in the Elderly (ABLE) study to focus on self-management behaviors, health literacy and illness beliefs of elderly adults with asthma. Participants included 328 English- and Spanish-speaking residents of New York City and Chicago older than 60 years and with moderate or severe asthma.

Results indicate that only about two in every five participants (37%) regularly used their inhaled corticosteroids. Medication adherence was assessed using the Medication Adherence Rating Scale (MARS), with “good adherence” defined as a mean MARS score of 4.5 or greater.

Among the study’s recommendations were that patients be counseled to store their ICS in the bathroom and that they make using it part of their daily routine.

Specifically, the study identified six strategies that could help elderly asthmatics adhere to their medication regimens:

• Keeping the medication in a usual location (used by 44.2 % of medication-adherent patients);
• Integrating medication use with a daily routine (32.6 %);
• Using the medication at a specific time (21.7 %);
• Taking the medication with other medications (13.4 %);
• Using the medication only when needed (13.4 %); and
• Using other reminders (11.9 %).

Study authors note that patients were more likely to regularly use their inhaled corticosteroids if they stored the product in the bathroom instead of next to their bed or elsewhere. Using the inhalers as part of daily routines also was effective, either in the morning while brushing their teeth or eating breakfast, or evenings when going to bed.

The most medication-adherent elderly asthmatics, who store their inhaled corticosteroids in the bathroom or who integrated its use into their daily routines, were most likely to be white, American by birth, and have at least a partial college education.

The researchers suggested it is possible for people to change how they adhere to using their medication with the correct counseling.

“People who keep their medication in the bathroom and those who integrate its use into a daily routine are best at remembering to use their medication,” the authors conclude.

U.S. Pharmacist Social Connect