Improving adherence to essential medication for asthma: Feasibility study for the ‘Perceptions and Practicalities Intervention’ (PAPI)


5.4 million people in the UK are currently receiving treatment for asthma costing the NHS approximately £1 billion per year. It is estimated that 75% of hospital admissions for asthma are preventable, as are 90% of the 1,000 UK annual deaths from asthma, with more effective self-management, particularly optimal adherence to appropriately prescribed medication.

Members of the project team have developed a suite of valid and reliable, ‘low impact’ assessment tools to identify non-adherence and tailor support to overcome perceptual and practical barriers to adherence. These are incorporated in a Perceptions and Practicalities Intervention (PAPI), which is designed to improve adherence to asthma medication by supporting patients and practitioners to identify and address the salient barriers and facilitators to adherence for individual patients. PAPI can be delivered via a range of vehicles including on-line programmes and mobile phone Apps, however, the approach has not been formally tested.

This project, is being conducted in collaboration with the Asthma UK Centre for Applied Research (AUK CAR) and our Child and Adolescent Theme partners. We have finalised and manualised the PAPI and are currently evaluating its feasibility and acceptability to patients and practitioners, and the costs of intervention. In the longer term we will apply for external funding to undertake a randomised controlled trial of the effectiveness and cost effectiveness of the adherence intervention. We are also adapting the intervention for application to children with asthma via an AUKCAR funded PhD which will complete in 2019.

The results of this project will benefit patients by: promoting informed choice about prescribed medicines and helping them to get the best form essential treatment so improving quality of life, reducing time off work and away from school and even, in some cases, helping to prevent avoidable deaths from asthma.

Principal investigator: Professor Rob Horne, University College London

Start date and duration: April 2015, three years

Partners and collaborators involved: University College London, Queen Mary University of London, and Clinical Commissioning Groups in East London, Asthma UK (research centre)