Adolescents with asthma often report poor medication adherence and asthma control. Cognitive factors embedded in the social cognitive theory including self-efficacy, outcome expectations, and barrier perceptions may explain poor asthma outcomes in this population. One study in the USA examined which these cognitive factors are inter-correlated and explained medication adherence and asthma control in urban adolescents.
According to the theory used in this study, the social cognitive theory (SCT); people intentionally contribute to their functioning life circumstances and therefore their health. Additionally, there are cognitive factors that affect people’s willingness to implement new behaviours. These cognitive processes include self-efficacy, outcome expectations, and perceptions about barriers to achieving desired behaviours. Bandura, who is one of the supporters of this theory, also theorised that individuals’ conviction to accomplishing an observed behaviour (eg, self-efficacy) and the effort it takes to perform the behaviour (eg, barrier perceptions) along with outcome expectations (i.e. what they are likely to get out of it) influence their willingness to attempt the behaviour.
This study showed that improving medication adherence and asthma control among adolescents may require a multifaceted approach. Interventions focused on increasing self-efficacy and addressing barriers, actual or potential, to medication adherence could ameliorate asthma disparities in urban adolescents.
The researchers suggest that clinicians need to be vigilant in detecting and addressing patient-perceived barriers to asthma management, whether actual or potential, to improve treatment adherence in adolescents. In addition, periodic assessment of the capacity to perform a wide range of self-management tasks and overcome psychosocial challenges to adherence is necessary to gauge and ensure the adequacy of self-efficacy that translates to proper disease management behaviour.
References
- Rhee, H., Wicks, M. N., Dolgoff, J. S., Love, T. M., & Harrington, D. (2018). Cognitive factors predict medication adherence and asthma control in urban adolescents with asthma. Patient Preference & Adherence, 12929-937. doi:10.2147/PPA.S162925
