TO ASSESS THE DRUG ADHERENCE, FACTOR AFFECTING ADHERENCE AND MANAGEMENT OF ACUTE ASTHMA CHILDREN'S IN TAMILNADU

The prevalence and associated burden of disease due to asthma, it is mandatory to obtain an optimal control of the disease and to improve outcomes for these patients. But it has been observed that there is very poor adherence to the therapy which leads to the suboptimal control of the disease. To study the adherence for therapy in asthma patients and to assess the impact of health education and self action plan in improving the adherence to the therapy. A prospective study was done in a total of 986 asthma patients over a period of 3 years. Once included in the study, the patients were followed up for a total of 12 weeks for calculation of non-adherence to the therapy. In non-adherent patients, we employed various health education strategies to improve the adherence in these cases. A total of 986 patients of asthma who were started on therapy over duration of 6 months were included in the study. At the end of 12 weeks, it was observed that, only 108 patients (10.95%) had regular adherence and 878 patients (89.05%) were non adherence to the therapy as prescribed for asthma. Factors that were associated with poor adherence were: Lower educational level status, poor socioeconomic status, cumbersome regimens, dislike of medication, Fears about side effects, beliefs, changing in regimen, and patient’s ill attitudes toward health. After employing the various strategies for improving the adherence in these patients, the adherence increased in patients (61.32%) among the earlier defaulted patients, while the remaining 188 patients (38.68%) were found to be non-adherence even after various educational techniques. Nonadherence in asthma management is a fact of life and no single adherence improving strategy probably will be as effective as a good physician and patient relationship. Optimal self-management allowing for optimization of asthma control by adjustment of medications may be conducted by either self-adjustment with the aid of a written action plan or by regular medical review. Individualized written action plans based on peak expiratory flow are equivalent to action plans based on symptoms.