Medikamentenadhärenz in der Asthmatherapie – eine strukturierte Übersicht

Zusammenfassung

Hintergrund: Asthma gehört zu den chronischen Erkrankungen mit der niedrigsten Adhärenz. Es soll dargestellt werden, welche Faktoren die Adhärenz beeinflussen, welche Messverfahren es gibt und mit welchen Maßnahmen sich die Adhärenz verbessern lässt. Außerdem werden ökonomische Aspekte schlechter Adhärenz diskutiert.

Methode: Im Rahmen einer systematischen Literaturrecherche wurden 53 relevante und aktuelle Arbeiten identifiziert und aufbereitet.

Ergebnisse: Zu den Ursachen einer schlechten Adhärenz gehören Überzeugungen und Verhalten der Patienten, Komorbiditäten, hier besonders psychische Komorbiditäten, die Arzt-Patientenbeziehung, Medikation und andere Faktoren. Inwiefern adhärenzsteigernde Maßnahmen kosteneffizient sind, ist noch nicht eindeutig belegt.

Schlussfolgerungen: Da die Asthmakontrolle entscheidend von der Adhärenz abhängt, ist die Entwicklung neuer Adhärenzprogramme, die auf die Individualität des Patienten eingehen, nötig.

Abstract

Background The adherence level of Asthma therapy is low. We provide a literature overview about the determinants of adherence in asthma therapy, and potential options that lead to an improvement of adherence. We also discuss cost issues of poor adherence.

Methods: A systematic literature search was conducted and 53 articles were identified.

Results: The most prominent driving factors of adherence are patient beliefs, comorbidities, physician-patient relationship, and medication regimen. The cost effectiveness of adherence improving measures has yet to be shown.

Conclusion: As asthma control is primarily depended on adherence, cost effective adherence programs need to be developed that respond to patients’ individual needs.

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