Short Version: Why Patients Stop Taking Their Controller Medications

-Many stop taking their medications when they don't show symptoms.

-Compliance implies passive and disinterested. Adherence implies an activated patient who willingly accepts their role and responsibility. So let's stop calling it compliance and start calling it adherence.

-Non-adherence increases morbidity, mortality, and healthcare costs.

-Most common reasons for Intentional Non-adherence:

1. Concerns about adverse effects - 65% of new prescriptions for inhaled corticosteroids are not refilled. Inhalation route of steroid administration does not necessarily equate to HPA axis suppression (i.e., growth retardation) or bone density issues.
2. Medications are too expensive - Many pharmaceutical firms offer rebates or special pricing for low income patients.
3. Not really that sick - Denial is a problem with asymptomatic patients. Conversation should be on the difference between effective long-term symptom control and a 100% cure.
4. Not wanting to get “hooked” - An counter to this perception would be to stress that the eventual goal is to achieve an improved overall quality of life.
5. Medications no longer work - When a regimen of inhaled corticosteroids is successful, subsequent doses may not be perceived as having any impact, as their role is now more preventative.
6. To gain attention - It is important that parents realize, especially with asthma, the possibility a recurrence of symptoms may indeed be the direct result of the child willfully deciding not taking their medications as directed. 

-Respiratory therapists possess all of the skills, attributes and talents needed to help foster sustained adherence.

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