Non-compliance amongst adolescents with asthma: listening to what they tell us about self-management

Background. Non-compliance with prescribed anti-asthma medication is considered to be a major problem. The reasons why adolescents may fail to comply with their regimen are poorly understood. Objectives. This study set out to understand better the reasons for non-compliance in adolescents with asthma. Methods. In-depth interviews were conducted with a sample of 49 adolescents, aged 14-20 years, diagnosed as asthmatic more than a year previously and attending a hospital asthma clinic in Greater Glasgow. The interviews focused on young people's feelings about their illness and on their illness-related behaviour, including self-management. Results. Most of the young people interviewed admitted that they had not always complied with their self-care regimens. Reasons given for non-compliance with prescribed medication in the past or at present were: forgetfulness, belief that the medication is ineffective, denial that one is asthmatic, difficulty using inhalers, inconvenience, fear of side effects, embarrassment and laziness. Conclusion. Most of those interviewed believed that compliance with prescribed medication was extremely important, with many having formed this belief following a negative experience which they attributed to their non-compliance. Nevertheless, barriers exist which mean that optimum self-care is not always achieved. It is suggested that future health care initiatives in this area be designed to provide practical information which aids the surmounting of these barriers and helps children and adolescents to be sufficiently aware of their own vulnerability at an early stage of their career as asthmatics. Peer education initiatives may meet these objectives, and more thought should be given to their development and optimum form.