Effect of inhaler medication adherence on quality of life among asthmatic patients in Erbil City
DOI:
https://doi.org/10.15218/zjms.2025.005Keywords:
Quality of life, Inhaler medication adherence, Asthma controlAbstract
Background and objective: Asthma is the most common health problem that impaired a patient’s quality of life (QoL). Metered dose inhaler is a key route for improving asthma control and quality of life, the objective of this study was to assess asthma inhaler medication adherence and its effect on the quality of life of asthmatic patients.
Methods: A cross-sectional study was employed at Rizgary and Hawler Teaching Hospital in Erbil City, in the Kurdistan Region of Iraq from March 2021 to November 2022. A non-probability/purposive sampling technique was used to choose 300 asthmatic patients. Data was collected through a questionnaire consist of demographical data, asthma quality of life, metered dose inhaler checklist, and an asthma control test. Chi-square, Mann Whitney u test and binary logistic regression were used to find out the result of the study and P value <0.05 was significant.
Results: Out of 300 patients with asthma, 58% were females, the mean age (±SD) was 46.7±9.04 years, 43% used the metered dose inhaler improperly, 61% was uncontrolled asthma and67%reported poor quality of life. The following variables were associated with a poor quality of life: age ≤40 (P = 0.023, OR = 1.95), insufficient family income (P = 0.020, OR= 1.92), duration of disease ≤ 10 years (P = 0008, OR= 2.30), and improper used meter dose inhaler (P = 0001, OR = 3.32) respectively.
Conclusion: Appropriate using the inhaler technique is associated with better quality of life in asthmatic patients. Healthcare providers teaching patients with asthma should have the basic skills and knowledge to use metered dose inhalers correctly to reduce readmission and mortality rate.
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References
Global Initiative for Asthma. Global strategy for asthma management and prevention. Updated 2022. https://ginasthma.org/wp-content/uploads/2016/04/ GINA-2016-main-report-tracked.
World Health Organization (WHO). Key facts of asthma. 2022. World health organization https://www.who.int/news-room/fact-sheets/detail/asthma
Centers for Disease Control and Prevention. National Health Interview Survey Data. 2020. Department of Health & Human Services. https://www.cdc.gov/asthma/nhis
Vrijens B, Sabina DG, Hughes DA, Przemyslaw K, Demonceau J, Ruppar T, et al. A new taxonomy for describing and defining adherence to medications. Br J Clin Pharmacol. 2012; 73:691-705. doi: 10.1111/j.1365-2125.2012.04167
World Health Organization (WHO). Adherence to long-term therapies: evidence for action. Geneva: 2003; World Health Organization. https://apps.who.int/iris/handle/10665/42682;
Makela MJ, Backer V, Hedegaard M, Larsson K. Adherence to inhaled therapies, health outcomes and costs in patients with asthma and COPD. Respir Med. 2013; 107:1481–90. doi: 10.1016/j.rmed.2013.04.005
Ahmad A, Sorensen K. Enabling and hindering factors influencing adherence to asthma treatment among adolescents: a systematic literature review. J Asthma. 2016; 53:862–8. doi: 10.3109/02770903.2016.1155217
Sadatsafavi M, McTaggart-Cowan H, Chen W, Mark FitzGerald J. Quality of life and asthma symptom control: room for improvement in care and measurement. Value Health. 2015; 18:1043-9. doi 10.1016/j.jval.2015.07.008
Martínez-Moragón E, Palop M, de Diego A, Serra J, Pellicer C, Casán P, ASMACOST Study Group. Factors affecting the quality of life of asthma patients in Spain: the importance of patient education. Allergologia Et Immunopathologia Opathologia. 2014; 31:42(5):476-84.
Olajos-Clow J, Minard J, Szpiro K, Juniper E, Turcotte S, Jiang X. Validation of an Electronic Version of the Mini Asthma Quality of Life Questionnaire. Respir Med. 2010; 104(5):658-67. doi: 10.1016/j.rmed.2009.11.017.
Bouwmeester C, Kraft J, Bungay KM. Optimizing inhaler use by pharmacist-provided education to community-dwelling elderly. Respir Med. 2015; 109(10):1363-8. doi: 10.1016/j.rmed.2015.07.013.
Chun EJ, Hong PZ, Yan LV, Rui L, Yun QJ, Heather P, et al. The Asthma Control Test (ACT) and Asthma Control Questionnaire (ACQ) for assessing asthma control: systematic review and meta-analysis. J Allergy Clin Immunol. 2013; 131(3):695-703. doi: 10.1016/j.jaci.2012.08.023.
Heethal JP, Khine KM, Kenneth WCF, Kum YZ, Irigo CI, et al. A survey on the quality of life in patients with bronchial asthma in an outpatient clinic in Malaysia. Br J Med Med Res. 2014; 4(5): 1187-94. doi:10.9734/BJMMR/2014/5985
Souza DS, Noblat LA, Santos PM. Factors associated with quality of life in patients with severe asthma: the impact of pharmacotherapy. J Bras Pneumol. 2015; 41(6):496-501. doi: 10.1590/S1806-37562015000004545.
Chogtu B, Holla S, Magazine R, Kamath A. Evaluation of relationship of inhaler technique with asthma control and quality of life. Indian J Pharmacol. 2017; 49(1):110-5. doi: 10.4103/0253-7613.201012.
Uchmanowicz I, Uchmanowicz B, Panaszek B, Rosińczuk J. Sociodemographic factors affecting the quality of life of patients with asthma. Patient Prefer Adherence. 2016; 345-54. doi: 10.2147/PPA.S101898.
Gonzalez-Barcala FJ, de la Fuente-Cid R, Tafalla M, Nuevo J, Caamaño-Isorna F. Factors associated with health-related quality of life in adults with asthma. A cross-sectional study. Multidiscip Respir Med. 2012; 7(1):32. doi: 10.1186/2049-6958-7-32.
Cherecheș-Panța P, Pop CF, Coblișan P, Man SC. The Impact of Socio-Economical Status on the Quality of Life of Children with Asthma. J Emerg Med Trauma Surg Care. 2020; 7:054. doi: 10.24966/ets-8798/100054
Ilmarinen P, Juboori H, Tuomisto LE, Niemelä O, Sintonen H, Kankaanranta H. Effect of asthma control on general health-related quality of life in patients diagnosed with adult-onset asthma. Sci Rep. 2019; 9(1):16107. doi: 10.1038/s41598-019-52361-9
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