Noncompliance with asthma therapy - Are there solutions?

Compliance with medication is essential if treatment is to be effective. No ncompliance can include underuse, overuse, and erratic use of medication; u nderuse being the most frequently reviewed. Generally estimated to be aroun d 10%-46%, noncompliance with asthma therapy is a serious problem and studi es have shown that compliance with the mainstay of asthma treatment, inhale d corticosteroids, is low. Oral therapy offers better compliance with treat ment, with many patients preferring tablets to inhalers. Different ways to monitor compliance include monitoring prescriptions, counting tablets, meas uring levels of medication in blood or urine, and measuring canister weight , although none are fully effective. Contributing factors to noncompliance with treatment include side effects, lifestyle, social and economic factors , method of drug delivery, and dosing. The consequences of these include in creased symptoms and asthma exacerbations, both of which can lead to increa sed morbidity. To improve compliance, causal factors need to be addressed; there is a need to educate patients and those who support them about the di sease and the importance of following the physician's recommendations. Vari ous self-management programs have also been established to improve patient compliance at a relatively low cost. Difficulties with treatment may be add ressed by simplifying the treatment regimen using oral therapy. A relativel y new class of oral agents, the leukotriene modifiers, is being increasingl y used in clinical practice.