Behavioral influences on prescription inhaler acquisition for persistent asthma in a patient-centered medical home.

BACKGROUND: Medication adherence can be said to begin with the patient acquiring, or picking up their prescribed medications. There has been considerable study of asthma patients' adherence beliefs once they have possessed medication; however, little is known about attitudes that facilitate or impede their acquisition of such medication.

OBJECTIVES: The purpose of this study was to examine the behavioral influences, motivation, and self-efficacy that may guide a patient's decision to pick up asthma controller medications from the pharmacy for the treatment of persistent asthma.

METHODS: A chart review of patients with an asthma diagnosis treated at an academic family medicine practice identified 582 English-speaking adults prescribed an asthma medication. Participants were contacted in a randomized order via telephone and asked to complete an investigator-developed survey based upon the Theory of Planned Behavior. Descriptive statistics, chi square and t-tests were used for data analysis.

RESULTS: 240 individuals were contacted, and 27 individuals consented and completed a survey. Eighteen individuals (67%) were prescribed a controller inhaler in the past year, fourteen of whom picked up their prescription from the pharmacy. Individuals who did not pick up their prescription reported more strongly than those who did that using their inhaler is important (P = 0.01). No other statistically significant differences were identified.

CONCLUSION: Use of an inhaler is important to the patient based upon survey results; however, this belief did not correlate with adherence. Future studies that investigate patient-specific motivators would allow practitioners to better target clinical interventions to improve medication adherence in patients with asthma.