ADS is funded by an NIHR Academic Clinical Lectureship. AB is an NIHR
Senior Investigator and additionally was supported by the NIHR Respiratory Disease.
RH was supported by the National Institute for Health Research (NIHR) Collaboration
for Leadership in Applied Health Research (CLAHRC) North Thames at Barts NHS
Trust. The views expressed are those of the author(s) and not necessarily those of
the NHS, NIHR or Department of Health

Bush, A

De Simoni, A

Fleming, L

Griffiths, C

Horne, R

BMJ Open

English

Objective To explore the barriers and facilitators to inhaled asthma treatment in adolescents with asthma. Design Qualitative analysis of posts about inhaler treatment in adolescents from an online forum for people with asthma. Analysis informed by the Perceptions and Practicalities Approach. Participants Fifty-four forum participants (39 adolescents ≥16 years, 5 parents of adolescents, 10 adults with asthma) identified using search terms ‘teenager inhaler’ and ‘adolescent inhaler’. Setting Posts from adolescents, parents and adults with asthma taking part in the Asthma UK online forum between 2006 and 2016, UK. Results Practical barriers reducing the ability to adhere included forgetfulness and poor routines, inadequate inhaler technique, organisational difficulties (such as repeat prescriptions), and families not understanding or accepting their child had asthma. Prompting and monitoring inhaler treatment by parents were described as helpful, with adolescents benefiting from self-monitoring, for example, by using charts logging adherence. Perceptions reducing the motivation to adhere included asthma representation as episodic rather than chronic condition with intermittent need of inhaler treatment. Adolescents and adults with asthma (but not parents) described concerns related to attributed side effects (eg, weight gain) and social stigma, resulting in ‘embarrassment of taking inhalers’. Facilitators to adherence included actively seeking general practitioners’/consultants’ adjustments if problems arose and learning to deal with the side effects and stigma. Parents were instrumental in creating a sense of responsibility for adherence. Conclusions This online forum reveals a rich and novel insight into adherence to asthma inhalers by adolescents. Interventions that prompt and monitor preventer inhaler use would be welcomed and hold potential. In clinical consultations, exploring parents’ beliefs about asthma diagnosis and their role in dealing with barriers to treatment might be beneficial. The social stigma of asthma and its role in adherence were prominent and continue to be underestimated, warranting further research and action to improve public awareness of asthma

Spiral - Imperial College Digital Repository

What do adolescents with asthma really think about adherence to inhalers? Insights from a qualitative analysis of a UK online forum

Queen Mary Research Online

OBJECTIVE: To explore the barriers and facilitators to inhaled asthma treatment in adolescents with asthma. DESIGN: Qualitative analysis of posts about inhaler treatment in adolescents from an online forum for people with asthma. Analysis informed by the Perceptions and Practicalities Approach. PARTICIPANTS: Fifty-four forum participants (39 adolescents ≥16 years, 5 parents of adolescents, 10 adults with asthma) identified using search terms 'teenager inhaler' and 'adolescent inhaler'. SETTING: Posts from adolescents, parents and adults with asthma taking part in the Asthma UK online forum between 2006 and 2016, UK. RESULTS: Practical barriers reducing the ability to adhere included forgetfulness and poor routines, inadequate inhaler technique, organisational difficulties (such as repeat prescriptions), and families not understanding or accepting their child had asthma. Prompting and monitoring inhaler treatment by parents were described as helpful, with adolescents benefiting from self-monitoring, for example, by using charts logging adherence. Perceptions reducing the motivation to adhere included asthma representation as episodic rather than chronic condition with intermittent need of inhaler treatment. Adolescents and adults with asthma (but not parents) described concerns related to attributed side effects (eg, weight gain) and social stigma, resulting in 'embarrassment of taking inhalers'. Facilitators to adherence included actively seeking general practitioners'/consultants' adjustments if problems arose and learning to deal with the side effects and stigma. Parents were instrumental in creating a sense of responsibility for adherence. CONCLUSIONS: This online forum reveals a rich and novel insight into adherence to asthma inhalers by adolescents. Interventions that prompt and monitor preventer inhaler use would be welcomed and hold potential. In clinical consultations, exploring parents' beliefs about asthma diagnosis and their role in dealing with barriers to treatment might be beneficial. The social stigma of asthma and its role in adherence were prominent and continue to be underestimated, warranting further research and action to improve public awareness of asthma

UCL Discovery

https://qmro.qmul.ac.uk/xmlui/bitstream/123456789/24463/2/De%20Simoni%20What%20do%20adolescents%20with%20asthma%202017%20Published.pdf

What do adolescents with asthma really think about adherence to inhalers? Insights from a qualitative analysis of a UK online forum

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Spiral - Imperial College Digital Repository

Queen Mary Research Online

UCL Discovery