The value of self-report assessment of adherence, rhinitis and smoking in relation to asthma control

  • Primary Care Respiratory Journal (2009) 18, 300305 (2009)
  • doi:10.4104/pcrj.2009.00037
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To explore the utility of self-report measures of inhaled corticosteroid (ICS) adherence, degree of rhinitis and smoking status and their association with asthma control.


Patients prescribed ICS for asthma at 85 UK practices were sent validated questionnaire measures of control (Asthma Control Questionnaire; ACQ) and adherence (Medication Adherence Report Scale), a two-item measure of smoking status, and a single-item measure of rhinitis.


Complete anonymised questionnaires were available for 3916 participants. Poor asthma control (ACQ >1.5) was associated with reported rhinitis (OR = 4.62; 95% CI: 3.71-5.77), smoking (OR = 4.33; 95%&S3.58-5.23) and low adherence to ICS (OR = 1.35; 95% CI: 1.18-1.55). The degree of rhinitis was important, with those reporting severe rhinitis exhibiting the worst asthma control, followed by those reporting mild rhinitis and then those reporting no rhinitis symptoms (F(2, 3913)=128.7, p<.001). There was a relationship between the number of cigarettes smoked each day and asthma control (F(5,655)=6.08, p<.001).


Poor asthma control is associated with self-reported rhinitis, smoking and low medication adherence. These potentially modifiable predictors of poor asthma control can be identified through a brief self-report questionnaire, used routinely as part of an asthma review.

Author information


  1. Centre for Behavioural Medicine, Department of Practice and Policy, The School of Pharmacy, University of London, BMA House, London, UK

    • Jane Clatworthy
    •  & Rob Horne
  2. Department of General Practice and Primary Care, University of Aberdeen, Foresterhill Health Centre, Aberdeen, UK

    • David Price
    • , Dermot Ryan
    •  & John Haughney


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Competing interests

DP has consultant arrangements with, Aerocrine, Boehringer Ingelheim, GlaxoSmithKline, Merck generics, Merck, Sharpe and Dohme, Schering-Plough and Teva. He or his team have received grants and research support for research in respiratory disease from the following organisations: UK National Health Service, Aerocrine, AstraZeneca, Boehringer Ingelheim, GlaxoSmithKline, Merck, Sharpe and Dohme, Novartis, Pfizer, Schering Plough and Teva. He has spoken for: Boehringer Ingelheim, GlaxoSmithKline, Merck, Sharpe and Dohme and Pfizer. He is director of Optimum Patient Care Ltd.

Corresponding author

Correspondence to Rob Horne.