Asthma control in adolescents: the importance of assessing adherence

Asthma control in adolescents: the importance of assessing adherence


  • Giorgio Ciprandi
  • Amelia Licari
  • Riccardo Castagnoli
  • Riccardo Ciprandi
  • Gian Luigi Marseglia


asthma, adherence, control, adolescent


Background Asthma control is the goal of the management, but some patients do not achieve adequate control. Adherence to prescriptions is a relevant factor in this issue. As very few studies addressed this problem in adolescents, we investigated this aspect in this setting.

Methods This cross-sectional study consecutively enrolled 87 adolescents (60 males, 27 females, median age 14.2 years) with asthma visited at a third-level pediatric clinic. We used two questionnaires: Morisky Medication Adherence Scale (MMAS-8) and TAI.

Results As regards MMAS-8, 23 (26.6%) adolescents had low adherence, 34 (39%) medium, and 30 (34.4%) high. Concerning TAI, 34 (39%) had low adherence, 43 (49.5%) medium, and 10 (11.5%) high. After stratification per asthma control grade, adolescents with partly-controlled asthma had the highest scores for medium adherence (p=0.0017 and 0.049, respectively for MMAS-8 and TAI).

Conclusions Adolescents with asthma have poor adherence independently to the asthma control grade. This failure implicates that more attention should be paid to this issue in clinical practice.


Duarte-de-Araujo A, Teixeira P, Hespanhol V, Correira-de-Sousa J. COPD: understanding patients’ adherence to inhaled medications. Int J COPD 2018;13:2767-2773

Pearce CJ, Fleming L. Adherence to medication in children and adolescents with asthma: methods for monitoring and intervention. Exp rev Clin Immunol 2018;14(12):1055-1063

Plaza V, Giner J, Curto E, Alonso-Ortiz MB, Orue MI, Vega JM, et al. Assessing adherence by combining the test of adherence to inhalers with pharmacy refill records. J Investig Allergol Clin Immunol 2021;31:58-64

De Simoni A, Horne R, Fleming L, Bush A, Griffiths C. What do adolescents with asthma really think about adherence to inhalers? Insight fro a qualitative analysis of a UK online forum. BMJ Open 2017;7:e015245

Vazquez-Ortiz M, Angier E, Blumchen K, Comberiati P, Duca B, DunnGalvin A, et al. Understanding the challenges faced by adolescents and young adults with allergic conditions: a systematic review. Allergy 2020;75:1850-1880

Rehman N, Morais-Almeida M, Wu AC. Asthma across childhood: improving adherence to asthma management from early childhood to adolescence. J Allergy Clin Immunol Pract 2020;8(6):1802-1807.e1

Tosca MA, Marseglia GL, Ciprandi G. The real-world “ControL’Asma” study: a nationwide taskforce on asthma control in children and adolescents. Allergol Immunopathol 2021;49:32-39

Morisky DE, Ang A, Krousel-Wood M, Ward HJ. Predictive validity of a medication adherence measure in an outpatient setting. J Clin Hypertens (Greenwich). 2008;10:348–354

Plaza V, Fernandez-Rodriguez C, Melero C, Cosio BG, Entrenas LM, de Llano LP, et al. Validation of the “Test of the adherence to inhalers”. J Aerosol med Pulmon Drug Del 2016;29:142-155

Kaplan A, Price D. Treatment adherence in adolescents with asthma. J Asthma Allergy 2020;13:39-49







How to Cite

Ciprandi G, Licari A, Castagnoli R, Ciprandi R, Marseglia GL. Asthma control in adolescents: the importance of assessing adherence. Acta Biomed [Internet]. 2022 Aug. 31 [cited 2024 Jul. 25];93(4):e2022264. Available from: