The effect of medication adherence on symptom control, airway inflammation and exacerbations in asthmatics

Aims: In Asthma patients with good compliance to treatment, symptoms, functional and inflammatory parameters are expected to be at normal levels. In our study, the effect of treatment compliance on asthma symptom control, airway inflammation, and attacks within 6 months in asthmatic patients was investigated. Methods: 113 patients who have been diagnosed with asthma for at least 6 months and were under inhaler treatment were included in the study. Respiratory function tests, asthma control test (ACT) and Morisky 8 items medication adherence scale (MMAS-8) were performed and exhaled nitric oxide (FENO) levels were measured. After 6 months, patients were questioned about any asthma exacerbations in this 6 months period. Results: According to ACT, 57.5% of patients were not under control. 49.6% of patients had poor medication adherence according to MMAS-8. 24.1% of patients had high FENO levels. There was no association between MMAS-8 scores and FENO levels (p=0.34 r=-0.091). There was positive correlation between ACT and MMAS-8 scores (r=0.371 p=0.001). ACT scores were higher in patients with low FENO levels (p = 0.01). 11 asthmatics experienced asthma exacerbation during 6 months follow-up period. Medication adherence was not found to be a significant factor for exacerbations, however baseline ACT scores and FEV1 values were lower in patients who experienced asthma attacks (r= -0.107, p = 0.002). Conclusion: As a result, our study demonstrated that medication adherence determined by MMAS-8 is an important factor of asthma symptom control.