Adolescent Decision-Making about Use of Inhaled Asthma Controller Medication: Results from Focus Groups with Participants from a Prior Longitudinal Study

Background. Adherence with inhaled controller medications for asthma is known to be highly variable with many patients taking fewer doses than recommended for consistent control of lung inflammation. Adherence also worsens as children become teenagers, although the exact causes are not well established. Objective. To use focus group methodology to examine beliefs, feelings, and behaviors about inhaled asthma controller medication in adolescents and young adults who had previously participated in a longitudinal study of asthma treatment adherence and outcome in order to develop more effective management strategies. Methods. Twenty-six subjects participated in 6 focus groups comprised of 3-5 young adults (age range 12-20 years). Verbatim transcripts of these groups were analyzed using the long-table method of content analysis to identify key themes raised by participants. Results. A variety of beliefs, feelings, and behaviors influence the adolescent's decision about how to use their asthma medication. Some of the adolescents understood the importance of daily medication and were committed to the treatment plan prescribed by their provider. Poorer adherence was the product of misinformation, incorrect assumptions about their asthma, and current life situations. Conclusions. These results, by highlighting potential mechanisms underlying both better and worse adherence, inform the development of strategies to improve adherence behavior in adolescents and young adults with asthma. Knowledge of the specific beliefs, feelings, and behaviors that underlie adolescents' use of inhaled asthma controller medication will help providers maximize treatment adherence in this notoriously difficult patient population.