Background - Clinical and demographic variables are poor predictors of
treatment adherence. This study therefore examined the relationships
between the patients' perception of their cystic fibrosis and their re
ported adherence to physiotherapy, exercise, pancreatic enzyme and vit
amin therapies. Methods - Sixty adults with cystic fibrosis completed
the Health Perception Scale, Health Locus of Control Scale, and the Ma
nchester Adult Cystic Fibrosis Compliance Questionnaire. Results - Rep
orted adherence to physiotherapy, exercise, pancreatic enzyme and vita
min therapies was not influenced by patients' perceptions of their pas
t, current and future disease severity, or their perceived susceptibil
ity to recurrent infections. The greater their level of worry regardin
g their disease, the more likely they were to adhere to their physioth
erapy (p < 0.002), pancreatic enzyme (p < 0.001) and vitamin (p < 0.00
1) regimens. No difference between the exercise adherent and non-adher
ent groups emerged regarding their level of worry. Compared with patie
nts who believed that they were in control of their health, those who
believed that their cystic fibrosis was controlled by others (family a
nd health professionals) reported greater levels of adherence to their
physiotherapy (p < 0.001), pancreatic enzyme (p < 0.001) and vitamin
(p < 0.001) therapies. In contrast, patients who adhered to their exer
cise regimen believed that they were in control of their disease to a
greater extent than those who did not (p < 0.003). Conclusions - Worry
ing about cystic fibrosis and the perception of having little personal
control over the disease facilitated treatment adherence. It is clear
that patients perceive exercise therapy differently from other forms
of treatment.