As a first step in designing an intervention to help improve asthma therapy in low income urban minorities, Maureen George, MSN, RN, CS, and colleagues from the University of Pennsylvania conducted focus groups with 15 low income, urban, African American adults with persistent asthma to assess the reasons they do not use prescribed asthma treatments.
Researchers sought to better understand the barriers to inhaled corticosteroid (IC) adherence the patients experience, identify strategies to improve IC adherence, and assess opinions regarding asthma providers and participation in clinical research.
Inhaled corticosteroids are recognized as the medications of choice for the treatment of chronic, persistent asthma by the National Asthma Education and Prevention Program (NAEPP) of the National Heart, Lung and Blood Institute (NHLBI). They are effective in reducing airway inflammation, hypersensitivity, swelling and mucous production.
From the focus groups, researchers discovered five primary themes characterizing barriers to IC use:
Improving communication between the healthcare provider and patient would assist in overcoming these barriers, researchers suggest. For example, the focus group participants believed that if they had accurate knowledge of side effects and knew the benefit of taking medication late instead of not at all, they would likelier do a better job with their IC therapy.
The patients also shared ideas for getting into the habit of taking medication on a regular basis by developing simple regimens, helping them to avoid social distractions. While these participants reported good relationships with their asthma care providers, they expressed a general distrust of the medical establishment and concern that information from side effects might be withheld from them.
The AAAAI is the largest professional medical specialty organization in the United States representing allergists, asthma specialists, clinical immunologists, allied health professionals and others with a special interest in the research and treatment of allergic disease. Allergy/immunology specialists are pediatric or internal medicine physicians who have elected an additional two years of training to become specialized in the treatment of asthma, allergy and immunologic disease. Established in 1943, the Academy has nearly 6,000 members in the United States, Canada and 60 other countries. The Academy serves as an advocate to the public by providing educational information through its Web site at www.aaaai.org or the toll free physician referral and information line at 1-800-822-2762.
Journal of Allergy and Clinical Immunology