The relationship of denial of illness and compliance with inhaled preventive medications in adults with asthma

Abstract

<p>This descriptive, longitudinal, exploratory study was designed to investigate the relationship between denial of illness and compliance with inhaled preventive medication in adults with asthma. The association of severity of asthma in relation to denial and compliance was also examined. Fifty-one adults diagnosed with asthma taking regularly prescribed inhaled preventive medications participated in the study. On average the Caucasian (78%) females (82%) were 42 years of age and were highly educated. The mean compliance rate measured over two weeks with a microelectronic monitor was 36% (n = 48). Lower compliance was significantly associated with lower levels of education, ages 18&ndash;28, unemployment status, and systemic steroid use. Affective denial was observed to be negatively associated with compliance (r = &minus;.31, p = .03); no association was observed with cognitive denial. Correlations among various measures of client, clinician and laboratory-assessed severity, although statistically significant, were too low to be of clinical significance. Client-assessed severity using the National Heart, Lung, and Blood Institute's categories was observed to be significantly associated with lower compliance (rs = &minus;.28, p = .05); and client-assessed severity using a Visual Analog Scale for Dyspnea was significantly associated with affective denial (rs = .28, p = .05). Findings from this study suggested that adults with asthma exhibit affective denial, and this may contribute to sub-optimal compliance with inhaled preventive medications. These findings support the need for objective laboratory assessment of severity which is the most valid assessment of asthma severity. Further research should focus on replication of these results with different populations, larger sample size, and the development of an objective scale to measure denial of illness.</p>