Development of Adherence Questionnaire for Children and Adolescents with Asthma
Monday, March 5, 2018
South Hall A2 (Convention Center)
Takao Fujisawa, MD FAAAAI, Mizuho Nagao, MD, PhD, Yumi Mizuno, PhD, Naoki Shimojo, MD, PhD, Natoka Itoh-Nagato, MD, PhD, Yukihiro Ohya, MD PhD, Takanori Imai, MD, Motohiro Ebisawa, MD PhD FAAAAI, Chizu Habukawa, Hiroshi Odajima, MD,PhD, Yasunori Sato, PhD
RATIONALE: , oor adherence leads to poor asthma control. Adherence, however, is often “hidden” by patients or even “unrecognized” by themselves and tends to be left unattended. It is important to properly identify poor adherence and factors to hinder adherence by a simple questionnaire.

METHODS: A 53-item working questionnaire was developed based on concepts obtained by semi-structured interview to adolescents with inhaled corticosteroids (ICS)-treated asthma. The questionnaire was administered to 445 patients (9-15 years old) with asthma on ICS. Adherence was separately evaluated by “confidential” questions to ask frequency of “forgetting to take medicine” by non-medical study staff. Then, 6 questions for assessing adherence were selected from the 53 questions by stepwise logistic regression methods. We named that set of questions the Pediatric Asthma Adherence Questionnaire (PAAQ). Validation of PAAQ was performed using answers to the questions from a separate group of 276 ICS-treated asthma patients of same age.

RESULTS: The 6 questions asked about recognition and awareness of medication and treatment, habitual behavior in taking medicine, fear for exacerbation, negative feeling to taking medicine, self-confidence in taking medicine and attention-deficit behavior. The 6-item logistic model showed good statistical fit and well discriminated poor adherence with AUC at 0.814 and 0.759, in development and validation datasets, respectively. PAAQ scores for the physicians’ ratings of adherence differed significantly in the hypothetical direction.

CONCLUSIONS: PAAQ may be a useful tool to evaluate adherence in children and adolescents with ICS-treated asthma.