Asthma is one of the most prevalent chronic conditions that presents amongst adolescents. Untreated asthma can be debilitating. Hence, for many adolescents the successful management of asthma relies on taking medicines. It has been observed that non-adherence to asthma medicines is widely reported during adolescence. The unique challenges inherent to the adolescent developmental phase have been implicated in this observation. A more comprehensive understanding of the reasons influencing adherence to medicines is needed before interventions to facilitate adherence can be implemented. This thesis aimed to explore what factors influenced medicines adherence in adolescents with asthma through a systematic review of 17 adherence enhancing interventions (AEls) in adolescents taking long-term medicines; 30 in-depth semi-structured interviews with adolescents aged 13 to 19 years old, of which 13 were photo-interviews; and a quantitative analysis of 248 online surveys completed by university students with asthma aged 18 or 19 years old. The systematic review identified focussing interventions on a narrow age range, involving parent/family support for complex medicines regimens and improving access to care, as factors impacting positively on adherence. The qualitative inquiry found that forgetting, having concerns about medicines, perceiving that asthma medicines were not necessary, unwillingness to respond to asthma symptoms and being ill-equipped as an asthma self- manager, negatively impacted adherence. Adolescents also reported a variety of strategies they used to facilitate medicines-taking. Hierarchical regression analysis modelling revealed that higher medicines concerns, lower belief in the necessity for medicines, binge drinking and not usually carrying inhalers were associated with low self-reported adherence by the 8- item Morisky Medication Adherence Scale (MMAS-8). The knowledge gleaned from this thesis provides policy makers, health care practitioners, researchers, and others responsible for caring for adolescents with asthma, with new evidence to consider when engaging efforts to understand and facilitate medicines-taking in this patient group.
| Identifer | oai:union.ndltd.org:bl.uk/oai:ethos.bl.uk:555804 |
| Date | January 2011 |
| Creators | Salema, Nde-Eshimuni Manase |
| Publisher | University of Nottingham |
| Source Sets | Ethos UK |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
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