Publication date

Shared decision making and associated medication adherence in patients with COPD and/or asthma.

Achterbosch, M., Dijk, L. van, Boven, J.F.M. van. Shared decision making and associated medication adherence in patients with COPD and/or asthma. International Journal of Clinical Pharmacy: 2023, 45, p. 256. Abstract of the 26th Annual Meeting of ESPACOMP, the International Society for Medication Adherence, Berlin, Germany, 17–19 November 2022
Read online

To assess the level of shared decision making (SDM) in patients with asthma/COPD in the Netherlands, its association with medication adherence and underlying mechanisms.

Cross-sectional survey using validated questionnaires. The survey was distributed among patients who used COPD/asthma medication through community pharmacies. SDM was assessed using the SDM-Q-9 and adherence (the implementation construct) with the TAI-10 questionnaire. The feeling of competence (PCS), relatedness (IOS) and feeling of autonomy (HCCQ) from the Self-Determination Theory were proposed as mediating variables for multivariate regression analyses.

From the included patients (n = 396 out of 2904 approached), 55% had asthma, 33.3% COPD and 15.7% had both asthma and COPD. A moderate score of 26.7 (SD 12.1) on the SDM-Q-9 (scale 0–45) was found and 58.8% of the patients (TAI \50) were marked as non-adherent. No significant correlation (r = 0.045) was found between SDM and medication adherence. The mediating variables correlated weak yet positively with SDM, but not with medication adherence.

A representative and heterogeneous patient sample was obtained. Nevertheless, non-response bias and response bias may have occurred. More importantly, the previous assumed and validated relationship between SDM and mediation adherence could not be confirmed.

SDM as experienced by patients with asthma/COPD has not yet been fully applied in daily clinical practice. This might be a reason why no relationship with adherence was found. More research is necessary into this relation and possible underlying mechanisms, e.g. using qualitative in-depth interviews.