PREDICTING PATIENT ATTITUDES TO ASTHMA MEDICATION

Background-Studies of patient attitudes to asthma and its control have focused on crisis action, and little attention has been paid to attit udes to regular preventive medication. It is not clear whether attitud es to regular medication are related to the degree of distress or inte rference with life perceived by patients as being caused by their asth ma. For this reason this study examined how far dislike of medication related to dislike of other aspects of interference of asthma with dai ly life. Methods-Three hundred and ninety one patients were surveyed w ith a questionnaire which assessed their dislike of the interference o f asthma with their physical, social, and emotional functioning, toget her with dislike of regular asthma medication. A response was received from 320 patients (82%). Results-Four attitude clusters were identifi ed. Recorded in descending factor order, these were (1) dislike of ast hma medication, (2) dislike of disability, (3) dislike of public life interference, and (4) dislike of social and emotional interference. Th e attitude clusters were not related: in particular, dislike of asthma medication could not be predicted from other dislikes, or from asthma best function ratio (ratio of best recorded peak expiratory flow rate in the previous year to predicted value), age, or sex. The most signi ficant predictors of the patients' dislike of taking their own inhaled steroid were (1) dislike of using bronchodilator, (2) dislike of ster oids generally, and (3) dislike of taking medicine every day. Conclusi ons-Patient attitudes to regular asthma medication are not related to general anxieties and dislikes about asthma, nor to the potential for asthma control as judged by the best function ratio. Patients were not always consistent in their attitude to inhaled steroids in general, n or to their own named inhaled steroid in particular. A general cluster of antimedication attitudes existed, independent of whether the medic ation was for prophylaxis or relief. Attitudes to asthma medication ma y be helpful in predicting patient behaviour.