Transcript Chronic Illness and Emotional Distress in Adolescence

Adherence to treatment:
How can it be improved?
Non-Adherent patient
Fulvio Braido
Allergology & Respiratory Diseases
University of Genoa
Factor influencing the clinical outcomes of therapy
Thorsson & Geller
Respiratory Medicine 2005; 99: 836-849
The extent of Non-Adherence
WHO report
50% of patients from developed countries with chronic disease
do not use their medications as reccommended.
971 ptz – 12 countries
ECRHS-1 (1990-1994) – ECRHS-2 (1998-2002)
Adherent subjects in ECRHS-1
Non Adherent subjects in ERCHS-1
543
428
Adherence in ECRH-2
Net change in adherence
53.4%
Nordic
-2%
67.6%
Mediterranean
+7.5%
76.4.0%
Continental
+15.0%
56.1%
Extraeuropean areas
+19.8%
Drug
Disease
Cognition
Effectiveness = Efficacy
Inhaler
X
Clinical effects
Side effects
Patient
Satisfaction
Adherence
Patient
Behaviour
Treatment
Schedule
Patient-Physician
Relationship
J Investig Allergol Clin Immunol 2006
Vol. 16(4):218-223
The concerns about the adverse effects of ICS, is not
necessarly related to actual experience, but rather to
beliefs about the link between regular use and dependency or
other perceived side effects.
Barriers to
Adherence
Osterberg L. &
Blasche T.
N.E.J.M. 4 August 2005
Allergic Rhinitis and Asthma ad hoc survey: Clinical and Psychological perspectives
F. Braido, I. Baiardini, S. Brandi, A. Porcu, G.W. Canonica
Allergy and Respiratory Diseases, DIMI, Genoa University, Genoa, Italy
504 asthmatic patients
27.8% of asthmatic patients experience three or less rhinitic symptoms,
41% from 4 to 6 symptoms,
31.2 % more than 6 symptoms.
These symptoms deeply interfere with daily life causing
sleep problems (87.3%),
lack of concentration (78.9%),
difficulties in spare time (71.8%) and sport (71.7%).
Rhinitis symptoms are responsible of the worsening of asthma, with
an increase of dyspnoea (86.3%),
cough (73.9%)
wheezing (59%).
Improving Asthma Control Study (IMPACT) – post hoc analisys