Time and risk preferences and the use of asthma controller medication

Pediatrics. 2013 Apr;131(4):e1204-10. doi: 10.1542/peds.2011-2982. Epub 2013 Mar 11.


Objectives: We investigated the role of risk tolerance, time preference, and asthma-specific attitudes in adherence to asthma control medications.

Methods: Students with persistent asthma completed an online survey on asthma beliefs, risk tolerance, and time preference (n = 47). The time preference questions measure the degree to which the individual discounts future outcomes and essentially prefers immediate gratification to delayed gratification. The risk tolerance questions indicate the individual's dislike of uncertainty about outcomes. We analyzed the relationship between the independent and dependent variables.

Results: Feelings of embarrassment and concern about medication, as well as risk tolerance and time preference, were found to be significant predictors of adherence to control medication in the logistic regression. Analysis of probabilities associated with different profiles shows that at high rates of risk tolerance and discounting of future outcomes, the probability of adherence is near 0 regardless of asthma-specific attitudes. Asthma attitudes have a statistically significant effect for individuals with low rates of risk tolerance and time preference.

Conclusions: The risk tolerance and time preferences of the target group should be considered when designing an asthma-intervention program. Individuals who strongly prefer immediate gratification over future benefits and are willing to tolerate uncertain outcomes are unlikely to adhere to controller medication, regardless of their asthma attitudes. In contrast, efforts to affect relevant attitudes will be most fruitful for individuals with low rates of risk tolerance and time preference. However, as we cannot extrapolate these results to a larger population, we must view them with caution.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Anti-Asthmatic Agents / therapeutic use*
  • Asthma / drug therapy*
  • Asthma / psychology
  • Attitude to Health
  • Female
  • Health Surveys
  • Humans
  • Logistic Models
  • Male
  • Medication Adherence / psychology*
  • Multivariate Analysis
  • Patient Preference
  • Personal Satisfaction
  • Personality*
  • Risk-Taking
  • Time Factors
  • Young Adult


  • Anti-Asthmatic Agents