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Abstract

Adherence is defined as ‘the extent to which a patient's behavior corresponds with recommendations from a health care provider’. In all chronic diseases, including asthma, patient nonadherence to medical recommendations is common. In asthma, low rates of adherence to preventive medication are associated with higher rates of hospitalization and death. Many patients choose not to take their medication because they perceive it to be unnecessary or because they are concerned about potential adverse effects. Approximately one third of asthma patients have strong concerns about adverse effects from inhaled corticosteroids (ICSs). Clinicians must be prepared to work in an ongoing partnership with patients to ensure that they are offered a clear rationale as to why ICS are necessary and to address their concerns about potential adverse effects. This approach, based on a detailed examination of patients’ perspectives on asthma and its treatment, and an open, nonjudgmental manner on the part of the clinician, is consistent with the idea of concordance. Both the efficacy of a medication and patient adherence to the therapeutic regimen influence the effectiveness of a treatment. This article will review the underlying reasons for patient nonadherence and describe the role played by clinicians in promoting optimal medicine management.