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For PhD Students

On 5 July at 15:00 in an open session of Rīga Stradiņš University (RSU) Medical Promotion Council to be held in the Hippocrates Lecture Theatre (16 Dzirciema iela, Rīga) Dins Šmits will defend his doctoral thesis “Treatment adherence of asthma patients in Latvia and factors related to adherence”. 

The subject of the doctoral thesis may be illustrated by the statement of the American pediatric surgeon Everett Koop, “Medicines won’t work with patients that don’t take them”, as non-adherence to therapy is one of the main reasons of insufficient asthma control. The overall adherence process consists of prescribing the right treatment, filling the prescription in the pharmacy, consistent intake of the prescribed medication and consistent treatment for the duration of the prescription. In everyday clinical practice, more attention is devoted to whether the physician has prescribed the proper treatment, thus being less concerned with how and whether the patient adheres to the doctor’s recommendations.

The assessment of patients’ asthma medication beliefs, cognitive and emotional perceptions may help to identify patients with poor adherence to treatment in clinical practice in order to draw additional attention to such patients and to increase the likelihood of such a patient taking their asthma medication regularly, thereby attaining the desired treatment goals and particularly control of the ailment.  

The principal objective of the thesis was to establish the existence of an association between the view of Latvian patients on asthma therapy, their cognitive and emotional perception of the disease, asthma therapy and control. Another objective of the study was to assess the level of adherence and its association with disease control in asthma patients in Latvia.

The study method applied was a cross-sectional patient survey, which served to determine the factors that affect adherence to treatment. Some of these factors are related to complexity of therapy, fear of the side effects of drugs, methods of intake, dosage regime, knowledge about the essence of the disease and associated complications, illness perception and social support. Medical beliefs, cognitive and emotional treatment perception are factors that are most related to medical adherence. 

The study has revealed that patient surveys, based on the content of the questions included, may help to identify patients with poor adherence to treatment in clinical practice and therewith choose the most suitable treatment or schedule time to provide additional information to the patient.

There is an association between beliefs about asthma medication, cognitive and emotional factors, illness perception, sociodemographic and socio-economic factors, adherence to medication and asthma control in Latvian asthma patients. 

Patients’ views on treatment, particularly their concerns and perception of the necessity for asthma treatment were associated with poor adherence to treatment.

The need for consent to asthma treatment and concerns regarding the necessity to use the prescribed asthma medication constantly increase the probability of poor asthma control.

The author of the thesis recommends using either the MMAS or the 5-item MARS scale in Latvian asthma patients to identify patients with poor treatment adherence. Thus, it may be valuable to routinely assess the concerns and necessity of asthma medication in patients within the Latvian healthcare system to improve treatment adherence in asthma patients. It is also recommended to develop and approve Latvian language terminology for treatment adherence .

The doctoral thesis of Dins Šmits is available here.