Pharmacy World & Science

, Volume 32, Issue 6, pp 795–798 | Cite as

“Patients don’t lie”; a view on adherence in asthma

  • Claus MøldrupEmail author
  • Jonathan Stein
  • Birthe Søndergaard
Research Article


Objective The primary objective of this article is to examine the extent of self-reported non-adherence among patients participating in a controlled trial of an asthma compliance optimization intervention. The secondary objective is to introduce a two-question questionnaire that is, in wording and design, a neutral tool for disclosure of non-adherence behaviour. Method Data in this study was obtained as part of a controlled trial on an SMS monitoring and compliance intervention developed for Danish asthma patients. The trial was conducted from November 2007 to May 2008. A total of 244 patients participated in the study. Two new designed nonadherence questions were asked in immediate succession. This practice, along with the wording of the questions and use of the Web as medium, constitute a new approach to self-reported adherence assessment. Results A total of 43.9% of the participants in the trial reported non-adherence to the medical dosage regime for which they had, only one question earlier, documented their awareness. Conclusion This illustrates that at least 43.9% of the participants in the trial dared to report nonadherence to asthma medication.


Asthma Compliance Denmark Non-adherence Questionnaire 



The study was funded by the Ministry of Health and Prevention in Denmark.

Conflicts of interest



  1. 1.
    Mullen PD. Compliance becomes concordance. BMJ. 1997;314(7082):691–692.Google Scholar
  2. 2.
    Hearnshaw H, Lindenmeyer A. What do we mean by adherence to treatment and advice for living with diabetes? A review of the literature on definitions and measurements. Diabet Med. 2006;23(7):720–8.CrossRefPubMedGoogle Scholar
  3. 3.
    Chatterjee JS. From compliance to concordance in diabetes. J Med Ethics. 2006;32(9):507–10.CrossRefPubMedGoogle Scholar
  4. 4.
    Cohen SM. Concept analysis of adherence in the context of cardiovascular risk reduction. Nurs Forum. 2009;44(1):25–36.CrossRefPubMedGoogle Scholar
  5. 5.
    Bissonnette JM. Adherence: a concept analysis. J Adv Nurs. 2008;63(6):634–43.CrossRefPubMedGoogle Scholar
  6. 6.
    Sabate E. Adherence to long-term therapies: evidence for action. Geneva, Switzerland: World Health Organization; 2003.Google Scholar
  7. 7.
    Osterberg L, Blaschke T. Adherence to medication. N Engl J Med. 2005;353(5):487–97.CrossRefPubMedGoogle Scholar
  8. 8.
    DiMatteo MR. Variations in patients’ adherence to medical recommendations: a quantitative review of 50 years of research. Med Care. 2004;42(3):200–9.CrossRefPubMedGoogle Scholar
  9. 9.
    Cramer JA. A systematic review of adherence with medications for diabetes. Diabetes Care. 2004;27(5):1218–24.CrossRefPubMedGoogle Scholar
  10. 10.
    Horne R, Weinman J, Barber N, Elliot R, Morgan M. Concordance, adherence and compliance in medicine taking. London: NHS SDO; 2005.Google Scholar
  11. 11.
    Glintborg B, Hillestrom PR, Olsen LH, Dalhoff KP, Poulsen HE. Are patients reliable when self-reporting medication use? Validation of structured drug interviews and home visits by drug analysis and prescription data in acutely hospitalized patients. J Clin Pharmacol. 2007;47(11):1440–9.CrossRefPubMedGoogle Scholar
  12. 12.
    Svarstad BL. Measuring adherence in community pharmacies: opportunities and challenges. J Am Pharm Assoc 2005;45(2):127–129.Google Scholar
  13. 13.
    Osterberg L, Blaschke T. Adherence to medication. N Engl J Med. 2005;353(5):487–97.CrossRefPubMedGoogle Scholar
  14. 14.
    Glass TR, De GS, Hirschel B, Battegay M, Furrer H, Covassini M, et al. Self-reported non-adherence to antiretroviral therapy repeatedly assessed by two questions predicts treatment failure in virologically suppressed patients. Antivir Ther. 2008;13(1):77–85.PubMedGoogle Scholar
  15. 15.
    Munoz-Moreno JA, Fumaz CR, Ferrer MJ, Tuldra A, Rovira T, Viladrich C, et al. Assessing self-reported adherence to HIV therapy by questionnaire: the SERAD (Self-Reported Adherence) Study. AIDS Res Hum Retroviruses. 2007;23(10):1166–75.CrossRefPubMedGoogle Scholar
  16. 16.
    Liu H, Miller LG, Hays RD, Wagner G, Golin CE, Hu W, et al. A practical method to calibrate self-reported adherence to antiretroviral therapy. J Acquir Immune Defic Syndr. 2006;43(Suppl 1):S104–12.PubMedGoogle Scholar
  17. 17.
    Wu JR, Moser DK, Chung ML, Lennie TA. Objectively measured, but not self-reported, medication adherence independently predicts event-free survival in patients with heart failure. J Card Fail. 2008;14(3):203–10.CrossRefPubMedGoogle Scholar
  18. 18.
    Quinlan PJ, Earnest G, Eisner MD, Yelin EH, Katz PP, Balmes JR, et al. Performance of self-reported occupational exposure compared to a job-exposure matrix approach in asthma and chronic rhinitis. Occup Environ Med. 2009;66(3):154–60.CrossRefPubMedGoogle Scholar
  19. 19.
    Bender B, Milgrom H, Rand C. Nonadherence in asthmatic patients: is there a solution to the problem? Ann Allergy Asthma Immunol. 1997;79:177–85.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media B.V. 2010

Authors and Affiliations

  • Claus Møldrup
    • 1
    Email author
  • Jonathan Stein
    • 1
  • Birthe Søndergaard
    • 1
  1. 1.Department of Pharmacology and Pharmacotherapy, Section for Social Pharmacy, Faculty of Pharmaceutical SciencesUniversity of CopenhagenCopenhagen Ø Denmark

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