What are the barriers and factors that influence medication adherence for adolescents with asthma?
Introduction
The proposed study investigates barriers and factors influencing medication adherence for adolescents with asthma, such as ethnicity, lack of nutritional support, and limited help from caregivers. Poor medication adherence is a common cause of treatment failure in adolescents with asthma.
Background of the Study
In adolescents, the asthma burden is exceptionally noticeable and is linked with increased occurrence and death rates compared with younger children. Kaplan and Price (2020) cited one cause for this as that approximately half of adolescents with asthma fail to take their medication correctly. Existing studies outline inadequate asthma control in adolescents as one of the factors contributing to poor treatment adherence (Zhang et al., 2023). Numerous pediatric studies report mean adherence rates of 50% or lower (Kaplan & Price, 2020). Patient’s quality of life can be improved by outlining the reasons for poor disease control and adherence. Improved health outcomes, reduced exacerbations, and decreased hospitalisation outline the signs of reasonable asthma control. Numerous studies have reported poor patient adherence to maintenance prescriptions and offered various reasons for controlling asthma(Amin et al., 2020; Jeminiwa et al., 2019; McQuaid, 2018; Mes et al., 2018).
Patients’ adherence to medication varies, with some only adhering to prescriptions during symptomatic episodes but not when they are symptom-free. Besides, some studies associate treatment adherence with patients’ health discernments or misinterpretations of their condition. For instance, McQuaid(2018) found culture and underlying beliefs as the leading cause of asthma controller medications underuse among ethnic minorities. On the other hand, Kaplan et al. (2020) state that overprescription by primary care practitioners may lead to increased short-acting beta-agonists (SABA). Zhang et al. (2023) associated factors, such as insufficient training on asthma management among medical professionals, the generalised definition of the illness, the higher maintenance costs, and the clinician-patient relationship with prescribing behaviour. The study further suggested that effective communication between healthcare professionals and patients is vital in encouraging asthma patients to adhere to their medication.
Increased medication adherence improves asthma control and health outcomes, reducing the danger of future asthma exacerbations and healthcare expenses. Thus, better comprehension of patient discernments and behaviours and the potential barricades to evaluating this adherence issue is essential (Zhang et al., 2023). Besides, the proposed study outlines the need to comprehend healthcare workers’ role in enabling these behaviours, attitudes, and methods for recommending treatments. Existing high-quality studies associate good adherence with a decreased risk of severe asthma exacerbations (Sleath et al., 2018). It is important to note that non-adherence is predominantly troubling in teenagers who have unique age-related difficulties in taking their medication that can adversely influence asthma control and following outcomes.
The Importance of the Study
The proposed study will provide a scientific foundation to guide evidence-based practice, enabling healthcare professionals to deliver the highest quality care. The study will identify barriers and factors that influence medication adherence for adolescents with asthma, which are vital to understanding and improving medication adherence. It will develop knowledge regarding medication adherence among asthmatic adolescents and promote health over the entire lifespan, care of patients, and nursing actions to promote patients’ ability to respond to actual or potential health problems related to asthma. The proposed study will also add to the existing body of literature, forming the foundation for future studies focusing on the same research area.
Research Aim
The primary aim of this literature review is to investigate the barriers and factors that influence medication adherence for adolescents with asthma.
Research Question
PEO
Population: Adolescents with asthma
Exposure: Medication
Outcome: Factors that influence medication adherence.
Based on the PEO framework above, the proposed study’s research question will be:
What are the barriers to medication adherence reported by adolescents with asthma? What are the most common barriers to medication adherence reported by adolescents with asthma?
Summary of the Literature Search
Literature searches will be carried out in PubMed, MEDLINE, PsycINFO, Scopus, Ovid Nursing Database, SpringerLink, Wiley Online Library, EBSCO (Nursing Reference Center Plus), ProQuest Nursing & Allied Health Source, and CINAHL (Cumulative Index to Nursing and Allied Health Literature). Besides, articles will be identified by hand-searching the reference list of included studies. A comprehensive search strategy will be designed, including standard and advanced search strategies using key terms and phrases. All study citations will be exported to reference management software to identify duplicates and screening based on the PRISMA recommendation.
List of Keywords
Medication adherence, asthma, adolescents, treatment, asthma control, exacerbation, asthma patients, and healthcare professionals.
Inclusion and Exclusion Criteria
The inclusion criteria will include articles answering research questions or offering background information on the research objective, including clinical trials assessing barriers and factors influencing medication adherence of asthmatic adolescents. Exclusion criteria will include non-English articles, those published more than five years ago, abstract-only papers, those without accessible full-text, systematic reviews, and studies with data not dependably extracted, replica, or overlapping.
PRISMA Summary
“The PRISMA framework will be used to identify and select relevant studies. It will outline the flow of information through the various phases of the systematic review, describing the inclusion and exclusion criteria for articles for data extraction.
Ethical Approval
An ethics approval will be obtained through the University Research Ethics Committee (UREC 1) as the study will not have human participants. This form will enable the university to keep a record confirming that the research has been subjected to ethical scrutiny. Further ethical approval will be obtained from the Faculty Research Ethics Committees (FRECs). Overall, the proposed study will include a statement of ethics approval and consent containing the name of the ethics committee that approved the study and the committee’s reference number, if applicable.
Data Summarisation
Data will be summarised in a data extraction table describing study characteristics, including the aim of the study, methodology, the sample, findings, study implications, strengths and weaknesses.
Data Analysis
Data analysis will encompass a critical appraisal that will begin with extracting data from the primary articles, followed by standardisation and analysis. Findings will then be presented using essential themes, including barriers to medication adherence among adolescents with asthma.
Summary and Conclusion
Overall, the proposed study will investigate the barriers and factors influencing medication adherence for asthma adolescents. It will include a systematic review of recently published articles on the current study area.
References
Amin, S., Soliman, M., McIvor, A., Cave, A., & Cabrera, C. (2020). Usage patterns of short-acting β2-agonists and inhaled corticosteroids in asthma: A targeted literature review. The Journal of Allergy and Clinical Immunology: In Practice, 8(8). https://doi.org/10.1016/j.jaip.2020.03.013
Jeminiwa, R., Hohmann, L., Qian, J., Garza, K., Hansen, R., & Fox, B. I. (2019). Impact of ehealth on medication adherence among patients with asthma: A systematic review and meta-analysis. Respiratory Medicine, 149, 59–68. https://doi.org/10.1016/j.rmed.2019.02.011
Kaplan, A., Mitchell, P. D., Cave, A. J., Gagnon, R., Foran, V., & Ellis, A. K. (2020). Effective asthma management: Is it time to let the air out of Saba? Journal of Clinical Medicine, 9(4), 921. https://doi.org/10.3390/jcm9040921
Kaplan, A., & Price, D. (2020).
treatment adherence in adolescents with asthma
. Journal of Asthma and Allergy, Volume 13, 39–49. https://doi.org/10.2147/jaa.s233268
McQuaid, E. L. (2018). Barriers to medication adherence in asthma. Annals of Allergy, Asthma & Immunology, 121(1), 37–42. https://doi.org/10.1016/j.anai.2018.03.024
Mes, M. A., Katzer, C. B., Chan, A. H., Wileman, V., Taylor, S. J., & Horne, R. (2018). Pharmacists and medication adherence in asthma: A systematic review and meta-analysis. European Respiratory Journal, 52(2), 1800485. https://doi.org/10.1183/13993003.00485-2018
Sleath, B., Gratie, D., Carpenter, D., Davis, S. A., Lee, C., Loughlin, C. E., Garcia, N., Reuland, D. S., & Tudor, G. (2018). Reported problems and adherence in using asthma medications among adolescents and their caregivers. Annals of Pharmacotherapy, 52(9), 855–861. https://doi.org/10.1177/1060028018766603
Zhang, X., Ding, R., Zhang, Z., Chen, M., Yin, Y., & Quint, J. K. (2023). Medication adherence in people with asthma: A qualitative systematic review of patient and Health Professional Perspectives. Journal of Asthma and Allergy, Volume 16, 515–527. https://doi.org/10.2147/jaa.s407552