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What do adolescents with asthma really think about adherence to inhalers? Insights from a qualitative analysis of a UK online forum

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Title: What do adolescents with asthma really think about adherence to inhalers? Insights from a qualitative analysis of a UK online forum
Authors: De Simoni, A
Horne, R
Fleming, L
Bush, A
Griffiths, C
Item Type: Journal Article
Abstract: Objective To explore the barriers and facilitators to inhaled asthma treatment in adolescents with asthma. Design Qualitative analysis of posts about inhaler treatment in adolescents from an online forum for people with asthma. Analysis informed by the Perceptions and Practicalities Approach. Participants Fifty-four forum participants (39 adolescents ≥16 years, 5 parents of adolescents, 10 adults with asthma) identified using search terms ‘teenager inhaler’ and ‘adolescent inhaler’. Setting Posts from adolescents, parents and adults with asthma taking part in the Asthma UK online forum between 2006 and 2016, UK. Results Practical barriers reducing the ability to adhere included forgetfulness and poor routines, inadequate inhaler technique, organisational difficulties (such as repeat prescriptions), and families not understanding or accepting their child had asthma. Prompting and monitoring inhaler treatment by parents were described as helpful, with adolescents benefiting from self-monitoring, for example, by using charts logging adherence. Perceptions reducing the motivation to adhere included asthma representation as episodic rather than chronic condition with intermittent need of inhaler treatment. Adolescents and adults with asthma (but not parents) described concerns related to attributed side effects (eg, weight gain) and social stigma, resulting in ‘embarrassment of taking inhalers’. Facilitators to adherence included actively seeking general practitioners’/consultants’ adjustments if problems arose and learning to deal with the side effects and stigma. Parents were instrumental in creating a sense of responsibility for adherence. Conclusions This online forum reveals a rich and novel insight into adherence to asthma inhalers by adolescents. Interventions that prompt and monitor preventer inhaler use would be welcomed and hold potential. In clinical consultations, exploring parents’ beliefs about asthma diagnosis and their role in dealing with barriers to treatment might be beneficial. The social stigma of asthma and its role in adherence were prominent and continue to be underestimated, warranting further research and action to improve public awareness of asthma.
Issue Date: 1-Jun-2017
Date of Acceptance: 5-Apr-2017
URI: http://hdl.handle.net/10044/1/49889
DOI: http://dx.doi.org/10.1136/bmjopen-2016-015245
ISSN: 2044-6055
Publisher: BMJ PUBLISHING GROUP
Journal / Book Title: BMJ OPEN
Volume: 7
Issue: 6
Copyright Statement: © 2017 The Author(s). This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/
Keywords: Science & Technology
Life Sciences & Biomedicine
Medicine, General & Internal
General & Internal Medicine
AUDIOVISUAL REMINDER FUNCTION
MEDICATION ADHERENCE
INTERNET FORUMS
CHRONIC ILLNESS
CHILDREN
INTERVENTIONS
HEALTH
CORTICOSTEROIDS
ADULTS
CARE
adherence
adolescent
asthma
inhalers
online forum
qualitative resesarch
Publication Status: Published
Article Number: ARTN e015245
Appears in Collections:National Heart and Lung Institute
Faculty of Medicine



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