Adherence to medication among adult asthma patients in the Middle East and North Africa: results from the ESMAA study
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. Assess the level of adherence in patients attending a routine consultation and th...
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| Veröffentlicht in: | Respiratory medicine 2021-01, Vol.176, p.106244-106244, Article 106244 |
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| container_title | Respiratory medicine |
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| creator | Bassam, Mahboub Behbehani, Naser Farouk, Hisham Alsayed, Mohamed Montestruc, Francois Al-Jahdali, Hamdan Iqbal, Mohamed Nizam Al Zaabi, Ashraf |
| description | 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.
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.
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.
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 |
| doi_str_mv | 10.1016/j.rmed.2020.106244 |
| format | Article |
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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.
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.
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.
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.
•First cohort of this size in Middle East and North Africa involving 11 countries.•Interdependencies between Level of exacerbation, adherence and control were rarely explored in asthma patients.•Identification of a phenotype subgroup of difficult to treat severe uncontrolled adherent asthma patients.</description><identifier>ISSN: 0954-6111</identifier><identifier>EISSN: 1532-3064</identifier><identifier>DOI: 10.1016/j.rmed.2020.106244</identifier><identifier>PMID: 33253971</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Adherence ; Asthma ; Asthma control ; Disease ; Disease control ; Epidemiology ; ESMAA ; Family physicians ; Health care ; Middle east ; MMAS-4 ; North africa ; Patient compliance ; Quality of life ; Questionnaires ; Smoking ; Sociodemographics ; Subgroups</subject><ispartof>Respiratory medicine, 2021-01, Vol.176, p.106244-106244, Article 106244</ispartof><rights>2020 Elsevier Ltd</rights><rights>Copyright © 2020 Elsevier Ltd. All rights reserved.</rights><rights>2020. Elsevier Ltd</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c428t-11e986d12eca6497f9a0838ec1a6047a20bc6b44451a7ddd4337891a54a249b33</citedby><cites>FETCH-LOGICAL-c428t-11e986d12eca6497f9a0838ec1a6047a20bc6b44451a7ddd4337891a54a249b33</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.rmed.2020.106244$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,777,781,3537,27905,27906,45976</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33253971$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bassam, Mahboub</creatorcontrib><creatorcontrib>Behbehani, Naser</creatorcontrib><creatorcontrib>Farouk, Hisham</creatorcontrib><creatorcontrib>Alsayed, Mohamed</creatorcontrib><creatorcontrib>Montestruc, Francois</creatorcontrib><creatorcontrib>Al-Jahdali, Hamdan</creatorcontrib><creatorcontrib>Iqbal, Mohamed Nizam</creatorcontrib><creatorcontrib>Al Zaabi, Ashraf</creatorcontrib><title>Adherence to medication among adult asthma patients in the Middle East and North Africa: results from the ESMAA study</title><title>Respiratory medicine</title><addtitle>Respir Med</addtitle><description>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.
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.
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.
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.
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.
•First cohort of this size in Middle East and North Africa involving 11 countries.•Interdependencies between Level of exacerbation, adherence and control were rarely explored in asthma patients.•Identification of a phenotype subgroup of difficult to treat severe uncontrolled adherent asthma patients.</description><subject>Adherence</subject><subject>Asthma</subject><subject>Asthma control</subject><subject>Disease</subject><subject>Disease control</subject><subject>Epidemiology</subject><subject>ESMAA</subject><subject>Family physicians</subject><subject>Health care</subject><subject>Middle east</subject><subject>MMAS-4</subject><subject>North africa</subject><subject>Patient compliance</subject><subject>Quality of life</subject><subject>Questionnaires</subject><subject>Smoking</subject><subject>Sociodemographics</subject><subject>Subgroups</subject><issn>0954-6111</issn><issn>1532-3064</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNp9kc1u1DAYRS0EaqctL8ACWWLDJoP_4jgVm6iaFqQWFpS15bG_MB4l8dR2kPr2dTrthgUrS77nXlk-CH2gZE0JlV_26ziCWzPClgvJhHiDVrTmrOJEirdoRdpaVJJSeorOUtoTQlohyAk65ZzVvG3oCs2d20GEyQLOAZc5b032YcJmDNMfbNw8ZGxS3o0GH0oCU07YTzjvAN955wbAmxJjMzn8I8S8w10fy8YljpBKN-E-hvEZ3_y66zqc8uweL9C73gwJ3r-c5-j39eb-6lt1-_Pm-1V3W1nBVK4ohVZJRxlYI0Xb9K0hiiuw1EgiGsPI1sqtEKKmpnHOCc4b1VJTC8NEu-X8HH0-7h5ieJghZT36ZGEYzARhTpoJKQlXTC3op3_QfZjjVF5XKKVqThsiC8WOlI0hpQi9PkQ_mvioKdGLFL3XixS9SNFHKaX08WV63i7Za-XVQgG-HgEof_HXQ9TJ-sWJ8xFs1i74_-0_Aavhm7M</recordid><startdate>202101</startdate><enddate>202101</enddate><creator>Bassam, Mahboub</creator><creator>Behbehani, Naser</creator><creator>Farouk, Hisham</creator><creator>Alsayed, Mohamed</creator><creator>Montestruc, Francois</creator><creator>Al-Jahdali, Hamdan</creator><creator>Iqbal, Mohamed Nizam</creator><creator>Al Zaabi, Ashraf</creator><general>Elsevier Ltd</general><general>Elsevier Limited</general><scope>6I.</scope><scope>AAFTH</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7U9</scope><scope>ASE</scope><scope>FPQ</scope><scope>H94</scope><scope>K6X</scope><scope>K9.</scope><scope>M7N</scope><scope>NAPCQ</scope><scope>7X8</scope></search><sort><creationdate>202101</creationdate><title>Adherence to medication among adult asthma patients in the Middle East and North Africa: results from the ESMAA study</title><author>Bassam, Mahboub ; Behbehani, Naser ; Farouk, Hisham ; Alsayed, Mohamed ; Montestruc, Francois ; Al-Jahdali, Hamdan ; Iqbal, Mohamed Nizam ; Al Zaabi, Ashraf</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c428t-11e986d12eca6497f9a0838ec1a6047a20bc6b44451a7ddd4337891a54a249b33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Adherence</topic><topic>Asthma</topic><topic>Asthma control</topic><topic>Disease</topic><topic>Disease control</topic><topic>Epidemiology</topic><topic>ESMAA</topic><topic>Family physicians</topic><topic>Health care</topic><topic>Middle east</topic><topic>MMAS-4</topic><topic>North africa</topic><topic>Patient compliance</topic><topic>Quality of life</topic><topic>Questionnaires</topic><topic>Smoking</topic><topic>Sociodemographics</topic><topic>Subgroups</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bassam, Mahboub</creatorcontrib><creatorcontrib>Behbehani, Naser</creatorcontrib><creatorcontrib>Farouk, Hisham</creatorcontrib><creatorcontrib>Alsayed, Mohamed</creatorcontrib><creatorcontrib>Montestruc, Francois</creatorcontrib><creatorcontrib>Al-Jahdali, Hamdan</creatorcontrib><creatorcontrib>Iqbal, Mohamed Nizam</creatorcontrib><creatorcontrib>Al Zaabi, Ashraf</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Virology and AIDS Abstracts</collection><collection>British Nursing Index</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>British Nursing Index</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Respiratory medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bassam, Mahboub</au><au>Behbehani, Naser</au><au>Farouk, Hisham</au><au>Alsayed, Mohamed</au><au>Montestruc, Francois</au><au>Al-Jahdali, Hamdan</au><au>Iqbal, Mohamed Nizam</au><au>Al Zaabi, Ashraf</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Adherence to medication among adult asthma patients in the Middle East and North Africa: results from the ESMAA study</atitle><jtitle>Respiratory medicine</jtitle><addtitle>Respir Med</addtitle><date>2021-01</date><risdate>2021</risdate><volume>176</volume><spage>106244</spage><epage>106244</epage><pages>106244-106244</pages><artnum>106244</artnum><issn>0954-6111</issn><eissn>1532-3064</eissn><abstract>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.
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.
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.
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.
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.
•First cohort of this size in Middle East and North Africa involving 11 countries.•Interdependencies between Level of exacerbation, adherence and control were rarely explored in asthma patients.•Identification of a phenotype subgroup of difficult to treat severe uncontrolled adherent asthma patients.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>33253971</pmid><doi>10.1016/j.rmed.2020.106244</doi><tpages>1</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adherence Asthma Asthma control Disease Disease control Epidemiology ESMAA Family physicians Health care Middle east MMAS-4 North africa Patient compliance Quality of life Questionnaires Smoking Sociodemographics Subgroups |
| title | Adherence to medication among adult asthma patients in the Middle East and North Africa: results from the ESMAA study |
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