Asthma can be managed—but only if the medication is used the right way, every day. Still, many people forget, skip doses, or stop taking their meds altogether. Why does this happen?
Sometimes, it’s a simple mistake. Other times, people don’t believe the medicine helps or think their asthma isn’t serious.
That’s why knowing how asthma medication adherence works is so important.
In this article, you will learn what causes nonadherence, how it affects asthma control, and what strategies actually help people stay on track.
| 🔑 Key Takeaways ➤ Patients are more likely to follow their treatment plan when they feel involved and understand why the medication matters. ➤ Some people skip their asthma medicine on purpose, while others forget or don’t know how to use it correctly. ➤ There are different types of nonadherence, like never filling the prescription, stopping early, or taking the wrong dose. ➤ Forgetfulness, unclear instructions, and high costs are common reasons why people don’t stick to their asthma medication. ➤ When doctors check in regularly and talk clearly, patients are more likely to stay on their treatment. ➤ Tools like inhaler trackers, refill reminders, and simple text messages can help you remember to take their medicine. |
How Asthma Medication Adherence Works
Asthma medication adherence has been studied as a key factor in how well people manage their condition.
According to a study, adherence to asthma medication isn’t just about following instructions. It’s about collaboration between the patient and the healthcare provider. This means both sides—doctor and patient—need to work together to make decisions about treatment.
Intentional vs. Unintentional Nonadherence
The beliefs and attitudes patients have toward their asthma medication can influence whether they stick to the plan or not.
For example, if someone thinks their asthma isn’t serious, or they don’t believe the medication helps, they may intentionally skip doses. This kind of nonadherence, which is driven by personal beliefs, is called intentional nonadherence.
On the other hand, unintentional nonadherence happens when patients forget to take their medications or don’t know how to use their inhaler properly. The World Health Organization found that many people with asthma simply don’t take their medicine as prescribed—some estimates show that adherence rates for chronic illnesses like asthma are only around 50%.
Types of Nonadherence
There are three main types of nonadherence to medication, each with different causes and consequences.
- Primary nonadherence
This happens when a patient never fills the prescription at all. It might seem surprising, but this is common.
This kind of behavior—called non-fulfillment adherence—can go unnoticed by both doctors and patients. In some cases, patients may not understand the importance of starting treatment, or they may not be convinced the medication is needed. Sometimes, it’s due to barriers like cost or confusion about the prescription.
Studies have found that about 10% to 92% of patients show some form of nonadherence, and skipping the pharmacy visit is often where it starts.
- Non-persistence
Here, a patient begins the medication but stops without talking to their doctor. This isn’t always a deliberate choice. Often, it’s the result of poor communication or a lack of follow-up.
Between 40% to 60% of patients couldn’t remember what their doctor had told them just an hour after the visit. Imagine how hard it must be to stick with a treatment plan if you’re unclear on what it even is.
Non-persistence can also happen when the patient runs into obstacles—like remembering to take a daily dose, affording a refill, or not seeing any immediate results.
Roughly half of all nonadherence is thought to be intentional, while the other half happens because people either forget or don’t fully understand the instructions.
- Non-conforming Behavior
Finally, there’s non-conforming behavior. This includes taking the medication at the wrong time, skipping doses, or not following the correct amount.
For example, someone might take two doses instead of one or forget doses on weekends. Nonadherence tends to be worse for chronic conditions. People with long-term diseases like asthma or hypertension often don’t have symptoms right away, so they may not feel the need to follow their regimen strictly.
In fact, patients with chronic illnesses take only about 50% of their prescribed medications, on average. And when regimens are complex—think multiple medications or tricky schedules—the risk of errors goes up. In one study, nearly half of patients cited forgetfulness as the reason for missing doses.
Benefits of Adherence
Research shows that when you take your medicine as prescribed, you have:
- Fewer flare-ups
- Lower healthcare costs
For example, one study found that better adherence improved control by nearly 20% and reduced the need for quick-relief inhalers. In another study, it revealed that 78% of patients rarely forgot their daily inhaler, while 22% did not follow their schedule. Patients who were diagnosed with asthma as children were less likely to stick to their daily routine.
In fact, 58% of those with poor adherence had been diagnosed before age 16, compared to only 23% among those who followed their treatment well. This study also found that the lower the age at diagnosis, the higher the risk of skipping doses.
This is especially concerning for asthma, where missing medication can lead to flare-ups, emergency visits, or hospitalizations. In fact, poor adherence in chronic conditions like asthma contributes to high healthcare costs and worse health outcomes.
| 💡 Did You Know? The ASK-20 questionnaire is a tool used by healthcare professionals to pinpoint obstacles that make it harder for patients to take their medication every day. It includes 20 questions that ask about different challenges, such as feeling overwhelmed by too many medications or having trouble remembering to take a dose. In one study, patients with poor adherence had a higher average total ASK-20 score—about 39 out of 60—compared to 35 for those who followed their treatment as prescribed. This means that patients who report more barriers on the ASK-20 are significantly more likely to miss doses. |
Strategies to Improve Adherence
Here are some strategies to improve adherence to asthma medication:
- Self-Management Education for Asthma
Effective asthma control begins with you knowing what to do—and why it matters. Education is key but generic info won’t cut it. For asthma patients, self-management education needs to be personalized, repeated, and easy to understand.
Low health literacy is a major roadblock in asthma care. You often forget instructions or don’t fully understand how your medication works. In a study, adults with asthma who received tailored self-management plans were three times more likely to achieve over 60% adherence. They also reported fewer night awakenings and less use of rescue inhalers—clear signs of better asthma control.
The best approach? Doctors should use simple language and ask patients to repeat key info back to them. That “tell-me-back” style confirms you really got it.
- Monitoring and Feedback to Boost Asthma Medication Use
Asthma isn’t a “set it and forget it” condition. You must take your controller meds consistently, even when you feel fine. That’s where monitoring and feedback come in.
One study tracked adults with asthma using electronic inhaler devices. When doctors gave feedback based on the data, adherence jumped above 70%—while the control group stayed below 50%.
In children with asthma, a home-based monitoring program had similar success. Caregivers received feedback on how well their child was using inhaled corticosteroids (ICS), and both medication use and asthma symptoms improved.
Even if electronic devices aren’t always practical, pharmacy refill data is a useful, low-cost tool. When doctors reviewed refill records during asthma visits, their patients were significantly more likely to stick to their meds—by as much as 35.7% higher adherence compared to those whose records were not reviewed.
- Asthma Office Visits and Meaningful Conversations
Office visits are opportunities to strengthen self-management. Your providers should use these moments to review inhaler technique, talk through medication schedules, discuss side effects, and assess adherence.
One study found that more frequent asthma visits led to better patient outcomes, including improved adherence. But the quality of communication matters, too.
One meta-analysis showed that when clinicians communicate clearly and respectfully, patients are more likely to follow their asthma treatment. Another study took it further—when asthma patients helped choose their own treatment plans (shared decision-making), they were more consistent with medication and had better control, fewer symptoms, and even improved lung function.
- Using Technology to Support Asthma Self-Management
Technology can help you manage asthma on the go. New tools like interactive voice response (IVR) systems and SMS text messages offer low-cost ways to keep you engaged and on track.
One study used automated phone calls to remind parents of children with asthma to give ICS medications. Parents who got the calls had 32% higher adherence than those who didn’t.
Texting works, too. One study tested personalized SMS messages with adults who had asthma. The messages addressed their beliefs about medication and reminded them to take it. The result? A 10% improvement in adherence. That’s a practical tool that’s easy to scale—but patients must be willing to receive texts.
Final Words
Sticking to asthma medication is not always easy, but it plays an essential role in staying healthy and avoiding flare-ups.
When you understand the treatment, feel supported by your doctor, and have tools that help you stay on track, you’re more likely to take your medicine the right way. Small steps—like using reminders, checking in often, and making sure instructions are clear—can lead to big improvements.
Frequently Asked Questions
Why do some people stop taking their asthma medicine when they feel better?
Because they think they don’t need it when they feel fine. But asthma needs daily treatment, even without symptoms.
What makes it hard for people to stick to their asthma medication?
Reasons include cost, side effects, forgetting, not understanding why it’s needed, or feeling embarrassed.
Can your relationship with your doctor affect how well you follow treatment?
Yes! If you trust your doctor and feel listened to, you’re more likely to take your meds the right way.
Why is asthma education so important?
If you understand how asthma and meds work, you’re more likely to take them right. Knowledge builds confidence.
What if I’m scared of side effects from my asthma medicine?
Talk to your doctor. Many people worry, but understanding the benefits helps ease those fears.
Is it okay to take asthma medicine only when I have symptoms?
No. Daily medicine helps prevent attacks, even if you feel okay. Skipping doses can make asthma worse.
Does culture or beliefs affect how people take asthma meds?
Yes. Some beliefs or stigma can lead people to hide their condition or skip treatment. Education helps.
Sources
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