Adolescents with asthma: A qualitative study of adherence with medication

Adherence to medication is a major issue in people with asthma. It is widely believed that adolescents are less adherent than other age groups. The aim of this qualitative study was to investigate the nature and process of adherence in adolescents with asthma. Perceptions of medication use are reported here. Methods: Adolescents aged 10-24 years were recruited from 3 tertiary asthma clinics. They and their parents were interviewed separately using in-depth interview techniques. Participants completed the Respiratory Health Questionnaire and Asthma Knowledge Questionnaire. Interview transcripts were analysed using content, thematic and semiotic modes of analysis. Results: 85 adolescents and parents were interviewed. Distinct themes emerged regarding medication use including the 'scientist' model of experimentation, autonomous medication management, normalisation of routines and time management, family beliefs and practice, public and peer interfaces, knowledge of preventative medication, and the importance of incident events in challenging previously accepted beliefs. In addition, perceptions of clinicians' consulting styles and understandings of young people's perspectives appeared to influence adherence beliefs and practices. Conclusions: Young people's beliefs about medication, aspects of personal routines and the prioritisation processes they use have been underestimated as factors effecting adolescent decision-making and adherence. Better outcomes could be achieved if clinicians incorporate an understanding of these more complex social and cultural aspects of adolescent perceptions as an intrinsic part of asthma management.