Factors related to good asthma control using different medical adherence scales in Latvian asthma patients: an observational study

NPJ Prim Care Respir Med. 2017 Jun 20;27(1):39. doi: 10.1038/s41533-017-0042-x.


One of the main challenges in asthma control is adherence to pharmaceutical treatment. The aim of this study was to test the association between adherence to asthma medication, control and medical beliefs, cognitive and emotional perceptions using three different validated questionnaires. Beliefs about asthma medicine, cognitive and emotional factors were determined in a cross-sectional survey of patients attending outpatient pulmonologist practices in Latvia (n = 352). The validated Beliefs about Medicines Questionnaire and the Brief Illness Perception Questionnaire were used. Adherence to asthma medication was assessed using the Morisky Medication Adherence Scale and two different versions of the Medication Adherence Reporting Scale. Several questions about necessity or concerns related to pharmaceutical treatment were able to predict poor adherence according to the Morisky scale. If the patient felt that without the asthma medication his life would be impossible, his risk to have poor treatment adherence was 46% reduced (odds ratio 0.54; 95% confidence interval 0.33-0.89). Furthermore, asthma patients who were convinced that their health depends on the asthma treatment were less likely to have poor treatment adherence (odds ratio 0.56: 95% confidence interval 0.32-0.97). In case the patient was concerned by the need to constantly use asthma medication or sometimes concerned by long-term effects of asthma medication the odds of poor treatment adherence were 1.96 (95% confidence interval 1.19-3.24) and 2.43 (95% confidence interval 1.45-4.08), respectively. In conclusion, medication beliefs, particularly concerns and necessity of asthma treatment were associated with poor treatment adherence when assessed with the Morisky or 5-item Medication Adherence Reporting Scale.

Asthma treatment: INVESTIGATING POOR ADHERENCE IN THE LATVIAN POPULATION: Concerns about treatment necessity and uses of asthma medication are key factors influencing poor treatment adherence in Latvia. There are multiple psychological and behavioral reasons why patients do not adhere to asthma treatment courses, including social and religious beliefs, and perceptions of chronic illness. Patient questionnaires and 'adherence scales' can help predict whether patients are likely to follow advice, but their efficacy differs for individual nations. Dins Smits at Riga Stradins University, Latvia, and co-workers analyzed responses to three questionnaires completed by 352 asthma patients to assess treatment perceptions and the best questionnaire option for the Latvian population. Concerns about the use of asthma medication and beliefs about treatment necessity were key factors in poor adherence. These were picked up by the Morisky and MARS 5-item scales, which the authors recommend for future use.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Anti-Asthmatic Agents / therapeutic use*
  • Asthma / drug therapy*
  • Asthma / psychology*
  • Cross-Sectional Studies
  • Female
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Latvia
  • Male
  • Medication Adherence*
  • Middle Aged
  • Surveys and Questionnaires


  • Anti-Asthmatic Agents