The Importance of Education and Medication, Essay Example

Abstract

Asthma remains one of the most complex and problematic health conditions in adolescents. Despite the growing prevalence of asthma in adolescent populations, in teenagers it is not easily detected. This paper presents the results of a brief literature review related to the role of education and medication compliance in preventing asthma exacerbation in teenagers. Recommendations for future research are provided.

Keywords: asthma, adolescents, teenagers, education, medication, compliance.

What Is the Importance of Education and Medication Compliance In Preventing Asthma Exacerbation in Teenagers? A Review of Literature

Asthma is fairly regarded as one of the most complicated and problematic chronic health conditions in adolescents. Despite the growing prevalence of asthma in adolescent populations, in teenagers is it not easily detected. There is an emerging consensus that education and medication compliance could prevent asthma exacerbation in teenagers. Contemporary researchers unanimously agree that education is the major instrument of positive behavioral changes in teenagers, whereas medication compliance has a potential to reduce the scope of symptoms and complications of asthma in adolescents. The current state of research suggests that education and medication compliance are of primary importance in preventing asthma exacerbation in teenagers. However, future research must focus on the analysis of factors affecting the quality of self-management and medication compliance in adolescents with asthma.

That education is a reliable instrument of positive behavioral changes in adolescents has been abundantly established. The current state of nursing research provides sufficient information about the role and implications of education for preventing asthma exacerbation in teenagers. Researchers have documented that knowledge of asthma, its consequences and complications is the principal mediator in positive health behaviors (Velsor-Friedrich, Vlasses, Moberley &Coover, 2004). Evidence-based studies support a belief that education could reduce the incidence and scope of asthma complications in adolescents. Here, Bruzzese et al (2008) investigated the relevance and efficacy of a school-based education program for urban teenagers with asthma. The results of their study suggest that school-based education interventionscould produce significant positive effects on asthma management and its outcomes in adolescent students (Bruzzese et al, 2008). Caregivers felt that they had better opportunities to solve problems related to asthma management in teenagers (Bruzzese et al, 2008). Teenagers, in turn, reported taking more steps to prevent asthma and being more responsible in medication compliance after the intervention (Bruzzese et al, 2008). The intervention did not help to reduce daytime symptoms of asthma in adolescent participants, but “students reported less night wakening due to asthma, an important market of asthma control and a finding consistent with other interventions with adolescents” (Bruzzese et al, 2008, p.108). These results were supported by Brasler and Lewis (2006), who discovered that teenagers’ involvement in the Asthma Education school-based program resulted in significant health improvements. According to Brasler and Lewis (2006), the program led to substantial improvements in adolescent self-management. The percentage of students reporting tardiness or absences due to asthma reduced from 17% to 8% (Brasler & Lewis, 2006). Only 34% teenagers reported episodes of asthma requiring a visit to a physician or emergency department, compared with 46% preprogram (Brasler & Lewis, 2006). Education reduced the percentage of teenagers using rescue inhalers (Brasler & Lewis, 2006). Overall, asthma education programs proved to be a reliable instrument of preventing asthma exacerbations in adolescents.

However, education alone cannot facilitate effective self-management in adolescents with asthma. The severity and frequency of asthma exacerbations directly depends upon medication compliance. Few studies researched the problem of medication compliance in teenagers with asthma. Generally, patient adherence to prescribed medications is considered as the main factor of success in medical treatment of any disease (Taddeo, Egedy & Frappier, 2008). However, the results of evidence-based studies controversial. Milgrom et al (1996) investigated the relationship between noncompliance and treatment failure in children with asthma. The main objective of the study was to evaluate children’s adherence to asthma treatment regimens and their potential to prevent asthma exacerbations (Milgrom et al, 1996). The researchers found that the median medication compliance for the participants who experienced exacerbations did not exceed 13.7%, with the median compliance of 68.2% for those who experienced no exacerbations (Milgrom et al, 1996). In a similar vein, Stern et al (2006) discovered that more-compliant individuals with asthma, including teenagers, were “significantly less likely to experience exacerbation than less-compliant asthmatic patients” (p.407). By contrast, Jonasson et al (1999) found no relationship between treatment adherence and symptom score in children and adolescents with asthma.

Medication compliance is believed to reduce the risks of hospital admissions in adolescents with asthma, as one third of asthma exacerbations and hospital admissions are due to improper actions taken by adolescents in self-management (Ordonez, Phelan, Olinsky & Robertson, 1998). Suboptimal treatment adherence and poor control precede and contribute to the acute crisis in teenagers with asthma (Ordonez et al, 1998). Unfortunately, treatment adherence remains a major problem for teenagers. Developmental and emotional issues, low peer support and family dysfunction greatly affect adolescent compliance with the prescribed medication regimen (Gavin et al, 1999; Taddeo et al, 2008). The current state of knowledge about the relationship between medication compliance and asthma exacerbation in teenagers is poor. Therefore, future research must focus on the analysis of factors affecting the quality of self-management and medication compliance in adolescents with asthma.

Conclusion

How to prevent exacerbations in teenagers with asthma is a difficult question. The current state of evidence-based nursing research supports a belief that education and medication compliance are important in preventing asthma exacerbation teenagers. Unfortunately, the relationship between medication compliance and health outcomes in teenagers with asthma is poorly understood. Future research must focus on the analysis of factors affecting the quality of self-management and medication compliance in adolescents with asthma.

References

Brasler, M. & Lewis, M. (2006). Teens: Taking control of asthma. Journal of School Health, 76(6), 269-272.

Bruzzese, J.M., Unikel, L., Gallagher, R., Evans, D. & Colland, V. (2008). Feasibility and impact of a school-based intervention for families of urban adolescents with asthma: Results from a randomized pilot trial. Family Process, 47(1), 95-113.

Gavin, L.A., Wamboldt, M.Z., Sorokin, N., Levy, S.Y. & Wamboldt, F.S. (1999). Treatment alliance and its association with family functioning, adherence, and medical outcome in adolescents with severe, chronic asthma. Journal of Pediatric Psychology, 24(4), 355-365.

Jonasson, G., Carlsen, K.H., Sodal, A., Jonasson, C. & Mowinckel, P. (1999). Patient compliance in a clinical trial with inhaled budesonide in children with mild asthma. European Respiratory Journal, 14(1), 150-154.

Milgrom, H., Bender, B., Ackerson, L., Bowry, P., Smith, B. & Rand, C. (1996).

Noncompliance and treatment failure in children with asthma. Journal of Allergy and Clinical Immunology, 98(6), 1051-1057.

Ordonez, G.A., Phelan, P.D., Olinsky, A. & Robertson, C.F. (1998). Preventable factors in hospital admissions for asthma. Archives of Disease in Childhood, 78(2), 143-147.

Stern, L., Berman, J., Lumry, W., Katz, L., Wang, L., Rosenblatt, L. & Doyle, J.J. (2006). Medication compliance and disease exacerbation in patients with asthma: A retrospective study of managed care data. Annals of Allergy, Asthma & Immunology, 97(3), 402-408.

Taddeo, D., Egedy, M. & Frappier, J.Y. (2008). Adherence to treatment in adolescents. Pediatrics & Child Health, 13(1), 19-24.

Velsor-Friedrich, B., Vlasses, F., Moberley, J. & Coover, L. (2004). Talking with teens about asthma management. The Journal of School Nursing, 20(3), 140-148.