Cognitive and emotional factors relation to treatment adherence in asthmatic patients in upper Egypt

Background
Evaluating patients’ cognitive and emotional states, along with their beliefs about asthma medicine, helps identify those likely to be nonadherent to their therapy. This study aimed to assess treatment adherence in Upper Egypt and its relationship with disease beliefs and other potential influencing factors, including socioeconomic status, education, medication burden, and cognitive function.


Patients and methods
This study is a cross-sectional patient survey conducted in a respiratory outpatient clinic. A total of 138 asthmatic patients were recruited during follow-up visits at least 4 weeks after the last exacerbation. Assessment tools included the Morisky Medication Adherence Scale, Beliefs about Medicines Questionnaire, Brief Illness Perception Questionnaire, Asthma Control Test, Montreal Cognitive Assessment, and Mini Asthma Quality of Life Questionnaire.


Results
In the current study, 62.3% of patients showed low adherence, 29.7% showed moderate adherence, and only 7.9% showed high adherence. Illness perception is significantly higher in the low adherence group (70/100) than in the moderate adherence group and the high adherence group. The greater number of medications [odds ratio (OR=0.31)], low educational level (OR=0.124), presence of comorbidities (OR=0.287), and previous emergency room visits (OR=0.197) are associated with less treatment adherence. Conversely, later age of asthma onset (OR=2.479) and higher disease control (OR=1.784) are associated with higher adherence.


Conclusion
Treatment adherence among asthmatic patients in Upper Egypt is predominantly low, strongly influenced by negative medication beliefs, multiple medications, low education, comorbidities, and previous emergency visits. Later disease onset and better asthma control positively affect adherence.