Grant: CIHR New Investigator

The high personal and financial costs of asthma appear to be related to poor asthma control. The availability of effective treatments suggests that asthma can be well controlled in most patients, though most (53-58%) Canadians remain poorly controlled. Achieving optimal asthma control relies upon several behavioral factors, particularly daily taking one's medication as prescribed. However, research suggests adherence rates are as low as 32% in patients with asthma. Participation in education programs has increased patient knowledge about the importance of medication adherence, but recent reviews indicate that these programs have not significantly changed medication taking behavior. The purpose of this study is to assess the impact of a brief intervention that uses motivational interviewing (MI) techniques, on asthma medication adherence in a sample of adult asthmatics. A total of 182 patients will be recruited, half of which will receive the intervention, and half of which will not. The primary outcome measure will be adherence to inhaled corticosteroids (ICS), a medication which must be taken daily to be effective. This will be measured at 6 and 12 months post-intervention by verifying how often patients fill their prescriptions. This is done by accessing pharmacy records and drug database files. Secondary outcome measures include: self-reported medication adherence, levels of asthma control, confidence in one's ability to manage asthma, and quality of life. Statistical analyses will compare adherence rates between the intervention and nonintervention groups, and statistical corrections will be made to ensure that other variables that could be associated with medication adherence (e.g., sex, age, asthma severity) cannot account for any post-treatment group differences. This study may provide support for the use of MI techniques to improve medication adherence and asthma outcomes, in order to improve asthma control and quality of life in asthmatics.