The Non-Compliant Asthmatic

John Bottrell Health Pro
  • Believe it or not, and unlike you and me, studies show most asthmatics are not compliant with the very medicines that are proven safe and proven to prevent and control their disease.  In other words, most are not gallant asthmatics.


    Yet it's these same folks who keep coming back to their doctors complaining of shortness of breath when exposed to their asthma triggers.  Why is this so?  What can be done?


    There are lots of reasons, or excuses, why people quit taking their medicines.  I think we pegged it a while ago when we discussed the asthma types


    I suppose some could be martyr asthmatics, which are too tough for treatment, and some phlegmatic asthmatics that stay calm and avoid doctors, and some recovered asthmatics who think falsely their asthma went away.

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    Supposedly some are of the Doubting Thomas sort who refuse to believe they have asthma, or sometimer asthmatics who simply forget they have asthma, or poor patient asthmatics who have goofus asthma doctors


    All these asthma types together configure the non-compliant asthmatic:  he does not take his asthma medicines as they are prescribed, and therefore risks poor asthma control.


    Regardless, study after study has proven that inhaled corticosteroids work better than any other asthma medicine at controlling chronic (it's always there) inflammation in the airways of asthmatics. 


    Study after study also has shown that as long as you rinse your mouth out well after using your inhaled corticosteroid, side effects are rare. 


    The catch here is that the asthmatic must take this medicine every day, even when he is feeling well -- especially when he is feeling well


    Yet this is not usually the case.  More often than not, the asthmatic quits taking his meds when he's feeling well -- studies find.  I bet many quit taking their meds simply because they don't feel like taking them anymore, and perhaps some due to simple laziness or even ignorance like Joe Goofus


    Recently I visited my doctor and he said, "Your one of the few asthmatics I have who likes Advair."


    "So, what do they take to control their asthma then?" I asked.


    "Nothing.  They come in every 6 months or so complaining their asthma is bad."  He smiled as he said this in a kind of "What can you do?" shrug of his shoulders.


    Well, what can you do though, really?  You can't force patients to be compliant. Yet a new study recently performed by Henry Ford Hospital in Detroit (you can read about here) shows that a good asthma doctor (learn how to tell if you have a good asthma doctor by clicking here) actually has the ability to improve compliance.


    Study author Dr. L. Keoki Williams said that, "Unfortunately, overall patient adherence to ICS (inhaled corticosteroid) medication is poor, accounting for an estimated 60 percent of asthma hospitalizations. So it's important, as we move forward with health care reform, to look for more effective ways to make sure patients stay with their prescription regimens."


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    She adds, and rightfully so, "Better inhaled corticosteroid adherence means better overall asthma control, and less hospitalization."


    In this regard, the study results are promising.  They show that patients are more likely to take their ICS as prescribed when their doctors keep a close eye over their medication usage.


    When doctors know exactly when patients are refilling their prescriptions, and how often, they can estimate how long each prescription lasts.  Thus, if a patient is not using his inhaled corticosteroid, the doctor will know.


    Then, at the next appointment, the doctor can reiterate the facts:  that compliance with your asthma medicine is essential to good asthma care.  

Published On: August 09, 2010