Background

Low levels of adherence to asthma medication is reported in many countries worldwide. Improved knowledge of adherence in the Middle East and North Africa (MENA) is needed to address this major public healthcare burden.

Objective

Assess the level of adherence in patients attending a routine consultation and the relationship between adherence, patient/disease characteristics, disease control, and quality of life.

Methods

A large-scale cross-sectional epidemiological study was performed on adults suffering from asthma for at least 1 year and without an acute asthma episode within 4 weeks. Adherence was assessed using the MMAS-4 questionnaire©. Predictive factors of adherence were analyzed with logistic regressions.

Results

Overall 7203 eligible patients were included in 577 sites. Mean age was 45.4 years (±14.7), 57.2% were female, mean BMI was 28.5 kg/m2 (±6.0), and 11% were active smokers. Good adherence was observed in 23.6% with a country effect (p < 0.001). Higher age, higher SF-8 Mental component score, and high level of control were associated with good adherence (p < 0.001). Patients treated with a fixed combination (ICS + LABA) have better adherence and patients treated with short-acting beta agonist alone have a lower adherence. Good adherence has been noted in 528 uncontrolled patients suggesting the existence of a subgroup difficult to treat and who have severe asthma.

Conclusions

Asthma adherence in the MENA is unsatisfactory with less than one quarter of asthma patients having good adherence. This finding highlights the need to improve access to treatment, ensure better control follow-up and improved education among healthcare providers and patients.

中文翻译：

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中东和北非成年哮喘患者对药物的依从性：来自 ESMAA 研究的结果

背景

据报道，全球许多国家对哮喘药物的依从性较低。需要提高对中东和北非 (MENA) 依从性的了解，以解决这一重大的公共医疗负担。

客观的

评估参加常规咨询的患者的依从性水平以及依从性、患者/疾病特征、疾病控制和生活质量之间的关系。

方法

对患有哮喘至少 1 年且 4 周内没有急性哮喘发作的成年人进行了一项大规模的横断面流行病学研究。使用MMAS-4问卷©评估依从性。使用逻辑回归分析依从性的预测因素。

结果

总共 7203 名符合条件的患者被纳入 577 个地点。平均年龄为 45.4 岁 (±14.7)，57.2% 为女性，平均 BMI 为 28.5 kg/m2 (±6.0)，11% 为主动吸烟者。23.6% 的患者依从性良好，具有国家效应（p < 0.001）。较高的年龄、较高的 SF-8 精神成分评分和较高的控制水平与良好的依从性相关（p < 0.001）。固定组合（ICS + LABA）治疗的患者依从性更好，而单独使用短效β受体激动剂治疗的患者依从性较低。在 528 名不受控制的患者中观察到良好的依从性，这表明存在一个难以治疗且患有严重哮喘的亚组。

结论

MENA 的哮喘依从性不令人满意，只有不到四分之一的哮喘患者具有良好的依从性。这一发现凸显了改善获得治疗的机会、确保更好地控制随访和改善医疗保健提供者和患者教育的必要性。