Potential barriers to and proposed facilitators of adherence in adolescence and young adulthood

Adherence barriersAdherence facilitators
Complex treatment regimenSimplified treatment regimen: combination inhalers, once daily options
Fear of side-effects, bad taste of ICSAsthma medicine education, inhaler technique optimisation, oral hygiene, alternative ICS options
Non-intentional, forgetfulness, busy scheduleDeveloping routines, smart inhalers, audio-visual reminders, mobile/web alerts, electronic monitors and feedback
Embarrassment, denialSupporting relationships, family or peer-led interventions, CBT#
Low self-efficacyMotivational interviewing
Cognitive difficultyLiteracy assessment, simplified treatment regimen
Negative perception of HCPsHCP team communication skills and motivational interviewing skills, non-judgemental with the aim to gain patient trust
Financial and social barriers, costs and affordability of treatmentConsideration of domestic and financial factors, treatment supply options, social services input
Maintaining adherenceShort- versus long-term adherence strategies, regular review by HCP

ICS: inhaled corticosteroids; HCP: healthcare professional; CBT: cognitive behaviour therapy. #: CBT is a psychological approach to change people's beliefs and behaviour; : health literacy represents the ability of an individual to obtain, read, understand and use healthcare information to make appropriate decisions and treatment plans.