Potential barriers to and proposed facilitators of adherence in adolescence and young adulthood
| Adherence barriers | Adherence facilitators |
| Complex treatment regimen | Simplified treatment regimen: combination inhalers, once daily options |
| Fear of side-effects, bad taste of ICS | Asthma medicine education, inhaler technique optimisation, oral hygiene, alternative ICS options |
| Non-intentional, forgetfulness, busy schedule | Developing routines, smart inhalers, audio-visual reminders, mobile/web alerts, electronic monitors and feedback |
| Embarrassment, denial | Supporting relationships, family or peer-led interventions, CBT# |
| Low self-efficacy | Motivational interviewing |
| Cognitive difficulty | Literacy assessment¶, simplified treatment regimen |
| Negative perception of HCPs | HCP team communication skills and motivational interviewing skills, non-judgemental with the aim to gain patient trust |
| Financial and social barriers, costs and affordability of treatment | Consideration of domestic and financial factors, treatment supply options, social services input |
| Maintaining adherence | Short- 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.