Factors associated with therapeutic non-adherence in asthmatic patients: A multicenter study in Algeria.

Introduction: Effective medication adherence, is a real global challenge that emerges as a pivotal factor influencing asthma control, exacerbation frequency, hospitalization rates and ultimately, mortality, morbidity and health care costs. In light of this, our study aimed to assess therapeutic adherence levels among asthmatic patients and identify factors contributing to non-adherence.

Methods: We conducted a descriptive, cross-sectional multicenter study, among asthmatic patients receiving outpatient or inpatient care across seven asthma centers located in two Algerian cities: Algiers (University Hospital Center of Benimessous, University Hospital Center of Bab el oued,EPSP of Zeralda, EPSP of Beraki and EPSP of Rouiba) and Constantine (Constantine University Hospital Center (CHU), EPSP of Constantine), between July and December 2023. We evaluated therapeutic adherence using the Morisky 8-item questionnaire, while a 12-item questionnaire assessed patients' knowledge levels. Logistic regression analysis enabled us to identify factors associated with non-adherence.

Results: Our study, involved 390 patients, with a median age of 34 years and a sex ratio of 1.5. Notably, 38.2% of asthmatic patients exhibited poor adherence to treatment. Multivariate analysis revealed several factors potentially linked to non-adherence, including, age, place of residence, employment status, access to social insurance, treatment type and complexity, auto-medication, occurrence of adverse effects, limited level of education and inadequate knowledge about asthma management. Furthermore, there was a significant correlation between non-adherence and a higher rate of asthma exacerbations, with a reported occurrence of 68%.

Conclusion: Our findings emphasize concerning levels of therapeutic adherence, given its impact on disease control and the quality of life of asthmatic patients. This underscores the importance of implementing a therapeutic education program aimed at improving treatment adherence by addressing the factors identified as barriers in clinical patient management.