What do adolescents with asthma really think about adherence to inhalers? Insights from a qualitative analysis of a UK online forum
ObjectiveTo explore the barriers and facilitators to inhaled asthma treatment in adolescents with asthma.DesignQualitative analysis of posts about inhaler treatment in adolescents from an online forum for people with asthma. Analysis informed by the Perceptions and Practicalities Approach.Participan...
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| Veröffentlicht in: | BMJ open 2017-06, Vol.7 (6), p.e015245-e015245 |
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| creator | De Simoni, Anna Horne, Robert Fleming, Louise Bush, Andrew Griffiths, Chris |
| description | ObjectiveTo explore the barriers and facilitators to inhaled asthma treatment in adolescents with asthma.DesignQualitative analysis of posts about inhaler treatment in adolescents from an online forum for people with asthma. Analysis informed by the Perceptions and Practicalities Approach.ParticipantsFifty-four forum participants (39 adolescents ≥16 years, 5 parents of adolescents, 10 adults with asthma) identified using search terms ‘teenager inhaler’ and ‘adolescent inhaler’.SettingPosts from adolescents, parents and adults with asthma taking part in the Asthma UK online forum between 2006 and 2016, UK.ResultsPractical 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.ConclusionsThis 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. |
| doi_str_mv | 10.1136/bmjopen-2016-015245 |
| format | Article |
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Insights from a qualitative analysis of a UK online forum</title><source>BMJ Open Access Journals</source><source>MEDLINE</source><source>DOAJ Directory of Open Access Journals</source><source>PubMed Central Open Access</source><source>EZB-FREE-00999 freely available EZB journals</source><source>PubMed Central</source><creator>De Simoni, Anna ; Horne, Robert ; Fleming, Louise ; Bush, Andrew ; Griffiths, Chris</creator><creatorcontrib>De Simoni, Anna ; Horne, Robert ; Fleming, Louise ; Bush, Andrew ; Griffiths, Chris</creatorcontrib><description>ObjectiveTo explore the barriers and facilitators to inhaled asthma treatment in adolescents with asthma.DesignQualitative analysis of posts about inhaler treatment in adolescents from an online forum for people with asthma. Analysis informed by the Perceptions and Practicalities Approach.ParticipantsFifty-four forum participants (39 adolescents ≥16 years, 5 parents of adolescents, 10 adults with asthma) identified using search terms ‘teenager inhaler’ and ‘adolescent inhaler’.SettingPosts from adolescents, parents and adults with asthma taking part in the Asthma UK online forum between 2006 and 2016, UK.ResultsPractical 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.ConclusionsThis 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.</description><identifier>ISSN: 2044-6055</identifier><identifier>EISSN: 2044-6055</identifier><identifier>DOI: 10.1136/bmjopen-2016-015245</identifier><identifier>PMID: 28615272</identifier><language>eng</language><publisher>England: BMJ Publishing Group LTD</publisher><subject>Administration, Inhalation ; Adolescent ; Adult ; Anti-Asthmatic Agents - therapeutic use ; Asthma ; Asthma - psychology ; Asthma - therapy ; Chronic illnesses ; Communication Barriers ; Drug Monitoring - methods ; Drug Monitoring - psychology ; Electronic monitoring ; Ethics ; Ethnicity ; Families & family life ; Female ; Humans ; Inhalers ; Inner city ; Internet ; London ; Male ; Medication Adherence - psychology ; Motivation ; Nebulizers and Vaporizers ; Parents & parenting ; Practice Patterns, Physicians ; Qualitative research ; Respiratory Medicine ; Respiratory therapy ; Social Perception ; Social Stigma ; Surveys and Questionnaires ; Teenagers</subject><ispartof>BMJ open, 2017-06, Vol.7 (6), p.e015245-e015245</ispartof><rights>Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.</rights><rights>2017 Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted. 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/ Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted. 2017</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b472t-1a3b2d80534b5caaeeab01a716a754acff2dbec8747832f4531a14b18680c8fa3</citedby><cites>FETCH-LOGICAL-b472t-1a3b2d80534b5caaeeab01a716a754acff2dbec8747832f4531a14b18680c8fa3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttp://bmjopen.bmj.com/content/7/6/e015245.full.pdf$$EPDF$$P50$$Gbmj$$Hfree_for_read</linktopdf><linktohtml>$$Uhttp://bmjopen.bmj.com/content/7/6/e015245.full$$EHTML$$P50$$Gbmj$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,27549,27550,27924,27925,53791,53793,77601,77632</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28615272$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>De Simoni, Anna</creatorcontrib><creatorcontrib>Horne, Robert</creatorcontrib><creatorcontrib>Fleming, Louise</creatorcontrib><creatorcontrib>Bush, Andrew</creatorcontrib><creatorcontrib>Griffiths, Chris</creatorcontrib><title>What do adolescents with asthma really think about adherence to inhalers? Insights from a qualitative analysis of a UK online forum</title><title>BMJ open</title><addtitle>BMJ Open</addtitle><description>ObjectiveTo explore the barriers and facilitators to inhaled asthma treatment in adolescents with asthma.DesignQualitative analysis of posts about inhaler treatment in adolescents from an online forum for people with asthma. Analysis informed by the Perceptions and Practicalities Approach.ParticipantsFifty-four forum participants (39 adolescents ≥16 years, 5 parents of adolescents, 10 adults with asthma) identified using search terms ‘teenager inhaler’ and ‘adolescent inhaler’.SettingPosts from adolescents, parents and adults with asthma taking part in the Asthma UK online forum between 2006 and 2016, UK.ResultsPractical 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.ConclusionsThis 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.</description><subject>Administration, Inhalation</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Anti-Asthmatic Agents - therapeutic use</subject><subject>Asthma</subject><subject>Asthma - psychology</subject><subject>Asthma - therapy</subject><subject>Chronic illnesses</subject><subject>Communication Barriers</subject><subject>Drug Monitoring - methods</subject><subject>Drug Monitoring - psychology</subject><subject>Electronic monitoring</subject><subject>Ethics</subject><subject>Ethnicity</subject><subject>Families & family life</subject><subject>Female</subject><subject>Humans</subject><subject>Inhalers</subject><subject>Inner city</subject><subject>Internet</subject><subject>London</subject><subject>Male</subject><subject>Medication Adherence - psychology</subject><subject>Motivation</subject><subject>Nebulizers and Vaporizers</subject><subject>Parents & parenting</subject><subject>Practice Patterns, Physicians</subject><subject>Qualitative research</subject><subject>Respiratory Medicine</subject><subject>Respiratory therapy</subject><subject>Social Perception</subject><subject>Social Stigma</subject><subject>Surveys and Questionnaires</subject><subject>Teenagers</subject><issn>2044-6055</issn><issn>2044-6055</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>9YT</sourceid><sourceid>ACMMV</sourceid><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNqNkU9v1DAQxS0EolXpJ0BClrhwSfHfxLmAUAVtRSUuVBytSeI0Xhx7azut9swXx9EuVeGEL2Npfu9pZh5Cryk5o5TX77t5E7bGV4zQuiJUMiGfoWNGhKhqIuXzJ_8jdJrShpQnZCsle4mOmKqLpGHH6NePCTIeAoYhOJN643PCDzZPGFKeZsDRgHM7nCfrf2LowpILOplofG9wDtj6CZyJ6SO-8sneTkU-xjBjwHcLOJsh23uDwYPbJZtwGEvn5isO3llv8BjiMr9CL0ZwyZwe6gm6-fL5-_lldf3t4ur803XViYbligLv2KCI5KKTPYAx0BEKDa2hkQL6cWRDZ3rViEZxNgrJKVDRUVUr0qsR-An6sPfdLt1shnXXCE5vo50h7nQAq__ueDvp23CvZcMFq2kxeHcwiOFuMSnr2ZaTOQfehCVp2lLCueJUFfTtP-gmLLFcYaVIK9tWNash31N9DClFMz4OQ4lec9aHnPWas97nXFRvnu7xqPmTagHO9kBR_5fjb197tqk</recordid><startdate>20170601</startdate><enddate>20170601</enddate><creator>De Simoni, Anna</creator><creator>Horne, Robert</creator><creator>Fleming, Louise</creator><creator>Bush, Andrew</creator><creator>Griffiths, Chris</creator><general>BMJ Publishing Group LTD</general><general>BMJ Publishing Group</general><scope>9YT</scope><scope>ACMMV</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88G</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>M2M</scope><scope>NAPCQ</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20170601</creationdate><title>What do adolescents with asthma really think about adherence to inhalers? Insights from a qualitative analysis of a UK online forum</title><author>De Simoni, Anna ; Horne, Robert ; Fleming, Louise ; Bush, Andrew ; Griffiths, Chris</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b472t-1a3b2d80534b5caaeeab01a716a754acff2dbec8747832f4531a14b18680c8fa3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Administration, Inhalation</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Anti-Asthmatic Agents - therapeutic use</topic><topic>Asthma</topic><topic>Asthma - psychology</topic><topic>Asthma - therapy</topic><topic>Chronic illnesses</topic><topic>Communication Barriers</topic><topic>Drug Monitoring - methods</topic><topic>Drug Monitoring - psychology</topic><topic>Electronic monitoring</topic><topic>Ethics</topic><topic>Ethnicity</topic><topic>Families & family life</topic><topic>Female</topic><topic>Humans</topic><topic>Inhalers</topic><topic>Inner city</topic><topic>Internet</topic><topic>London</topic><topic>Male</topic><topic>Medication Adherence - psychology</topic><topic>Motivation</topic><topic>Nebulizers and Vaporizers</topic><topic>Parents & parenting</topic><topic>Practice Patterns, Physicians</topic><topic>Qualitative research</topic><topic>Respiratory Medicine</topic><topic>Respiratory therapy</topic><topic>Social Perception</topic><topic>Social Stigma</topic><topic>Surveys and Questionnaires</topic><topic>Teenagers</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>De Simoni, Anna</creatorcontrib><creatorcontrib>Horne, Robert</creatorcontrib><creatorcontrib>Fleming, Louise</creatorcontrib><creatorcontrib>Bush, Andrew</creatorcontrib><creatorcontrib>Griffiths, Chris</creatorcontrib><collection>BMJ Open Access Journals</collection><collection>BMJ Journals:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Psychology Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Access via ProQuest (Open Access)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>BMJ open</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>De Simoni, Anna</au><au>Horne, Robert</au><au>Fleming, Louise</au><au>Bush, Andrew</au><au>Griffiths, Chris</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>What do adolescents with asthma really think about adherence to inhalers? Insights from a qualitative analysis of a UK online forum</atitle><jtitle>BMJ open</jtitle><addtitle>BMJ Open</addtitle><date>2017-06-01</date><risdate>2017</risdate><volume>7</volume><issue>6</issue><spage>e015245</spage><epage>e015245</epage><pages>e015245-e015245</pages><issn>2044-6055</issn><eissn>2044-6055</eissn><abstract>ObjectiveTo explore the barriers and facilitators to inhaled asthma treatment in adolescents with asthma.DesignQualitative analysis of posts about inhaler treatment in adolescents from an online forum for people with asthma. Analysis informed by the Perceptions and Practicalities Approach.ParticipantsFifty-four forum participants (39 adolescents ≥16 years, 5 parents of adolescents, 10 adults with asthma) identified using search terms ‘teenager inhaler’ and ‘adolescent inhaler’.SettingPosts from adolescents, parents and adults with asthma taking part in the Asthma UK online forum between 2006 and 2016, UK.ResultsPractical 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.ConclusionsThis 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.</abstract><cop>England</cop><pub>BMJ Publishing Group LTD</pub><pmid>28615272</pmid><doi>10.1136/bmjopen-2016-015245</doi><oa>free_for_read</oa></addata></record> |
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| source | BMJ Open Access Journals; MEDLINE; DOAJ Directory of Open Access Journals; PubMed Central Open Access; EZB-FREE-00999 freely available EZB journals; PubMed Central |
| subjects | Administration, Inhalation Adolescent Adult Anti-Asthmatic Agents - therapeutic use Asthma Asthma - psychology Asthma - therapy Chronic illnesses Communication Barriers Drug Monitoring - methods Drug Monitoring - psychology Electronic monitoring Ethics Ethnicity Families & family life Female Humans Inhalers Inner city Internet London Male Medication Adherence - psychology Motivation Nebulizers and Vaporizers Parents & parenting Practice Patterns, Physicians Qualitative research Respiratory Medicine Respiratory therapy Social Perception Social Stigma Surveys and Questionnaires Teenagers |
| title | 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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