Control of asthma, adherence to inhaled therapy and usefulness of the Test of Adherence to Inhalers (TAI). Results of the ASCONA study

Objetives: To validate the TAI in the clinical practice setting for identifying deficient adherence to therapy associated to poor asthma control; and to identify other factors of inhaled therapy in poor control of the disease. Methods: A non-postmarketing, cross-sectional, multicenter observational study, involving patients of either sex, aged ≥ 18 years with stable moderate-severe persistent asthma. The following was carried out in a single visit: collection of asthma morbidity and clinical data; level of control (Asthma Control Test [ACT]); general satisfaction with treatment (Treatment Satisfaction Questionnaire for Medication [TSQM) and specific satisfaction with the inhaler (Feeling of Satisfaction with Inhaler [FSI-10]); general adherence to therapy (Morisky-Green) and specific adherence to inhalers (Test of Adherence to Inhalers [TAI]); and quality of life (Mini-Asthma Quality of Life Questionnaire [MiniAQLQ]). Results: 778 patients were included. Bivariate statistical analysis showed non-controlled asthma patients, were older, with more exacerbations, poorer lung function, poorer inhaler use, less adherent to therapy, higher rates referred to type of non-adherence (sporadic, intentional, inadvertent), and poorer treatment satisfaction and quality of life. Logistic regression analysis found good asthma control to be correlated to: high specific inhaler satisfaction, high general satisfaction, and high inhaler adherence (TAI). Investigator stimated 14,5% non adherence, TAI yielded 60,5% non adherence rates. Conclusion: The TAI is useful for identifying deficient adherence as a possible cause of poor asthma control and physicians overstimate adherence.