Attitudes, barriers, and facilitators for the use of rescue therapy in patients with mild to moderate asthma

Abstract

Objective: To explore and understand the barriers and facilitators for correctly using maintenance/controller and rescue treatments in adults with mild to moderate asthma (GINA 2020 classification) attending a reference center for asthma in Bogotá, Colombia, during the years 2021–2022. Methods: A qualitative study with a phenomenological approach using semi-structured interviews with adults with mild to moderate asthma, under a purposive non-probabilistic sampling. Data analysis was conducted using Nvivo software (Version 11.0) through: reading and re-reading, memo generation, coding, category generation, and connection between categories. Results: Thirty-one patients were interviewed (mean age: 44.3 years) with a 1:1 male/female ratio. 77.4% with moderate asthma. Patients’ experiences were grouped into three themes with 12 categories: barriers related to the individual (inadequate knowledge about maintenance inhalers, insufficient understanding of their current state due to lack of information, disagreement in treatment among non-adherent patients, and difficulties in implementation and practical application), barriers related to the healthcare system (lack of follow-up, medication availability, administrative procedures, and waiting times), and patient-related facilitators (adequate knowledge of the functioning and correct use of inhalers for treatment, proactive attitude, and motivation to receive information). Conclusion: Based on the identified barriers, educating patients about the pathophysiological mechanisms of asthma (inflammation and bronchodilation) and the concept of control adapted to the patient’s language could facilitate the appropriate and adherent use of pharmacological therapy.