The Effect of Counseling on Knowledge and Adherence among Asthma Patients at the Pulmonary Clinic of dr. Rasidin Regional General Hospital, Padang
Article Sidebar
Main Article Content
Page: 1033-1055
Abstract
Asthma is a chronic respiratory disease characterized by airway inflammation and narrowing, leading to symptoms such as coughing, shortness of breath, and wheezing. The prevalence of asthma remains high both globally and nationally, resulting in significant health and economic burdens. Pharmacist counseling has been shown to play an important role in improving patients’ knowledge and medication adherence, thereby supporting disease control and preventing recurrence. This study employed a pre-experimental design using a one-group pretest–posttest approach. The research sample consisted of 68 outpatient asthma patients from the pulmonary polyclinic selected using purposive sampling technique. Patients’ knowledge was assessed using the Asthma General Knowledge Questionnaire (AGKQ), while medication adherence was measured using the Medication Adherence Report Scale (MARS-10). Data were analyzed using the Wilcoxon test and the Chi-Square or Fisher’s Exact test, with a significance level set at p < 0.05. The results indicated that pharmacist counseling significantly improved both knowledge and medication adherence among asthma patients (p = 0.000). However, no statistically significant relationship was found between knowledge and adherence at the pretest stage (p = 0.119) or the posttest stage (p = 1.000), which may be attributed to data homogeneity following counseling. In conclusion, pharmacist counseling is effective in enhancing knowledge and medication adherence in asthma patients. Therefore, counseling should be routinely implemented as part of clinical pharmacy services to support optimal asthma control.
Downloads
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
References
Bateman ED, Hurd SS, Barnes PJ, Bousquet J, Drazen JM, FitzGerald M, et al. Global strategy for asthma management and prevention: GINA executive summary. Eur Respir J 2008;31:143–78. DOI: https://doi.org/10.1183/09031936.00138707
Reddel HK, Bacharier LB, Bateman ED, Brightling CE, Brusselle GG, Buhl R, et al. Global Initiative for Asthma Strategy 2021: executive summary and rationale for key changes. Am J Respir Crit Care Med 2022;205:17–35. DOI: https://doi.org/10.1164/rccm.202109-2205PP
Organization WH. Adherence to long-term therapies: evidence for action. World Health Organization; 2003.
Oh J, Kim S, Kim MS, Abate YH, Abd ElHafeez S, Abdelkader A, et al. Global, regional, and national burden of asthma and atopic dermatitis, 1990–2021, and projections to 2050: a systematic analysis of the Global Burden of Disease Study 2021. Lancet Respir Med 2025;13:425–46. DOI: https://doi.org/10.1016/S2213-2600(25)00003-7
Rabe APJ, Loke WJ, Gurjar K, Brackley A, Lucero-Prisno III DE. Global burden of asthma, and its impact on specific subgroups: nasal polyps, allergic rhinitis, severe asthma, eosinophilic asthma. J Asthma Allergy 2023:1097–113. DOI: https://doi.org/10.2147/JAA.S418145
Notoatmodjo S. Promosi Kesehatan dan Ilmu Perilaku. Jakarta: PT Rineka Cipta; 2012.
S, Notoatmodjo. Promosi Kesehatan dan Ilmu Perilaku 2010.
Neswita E, Laia M, Ardilla HY, Nurkholifah S, Ginting AS, Lubis AA, et al. Pengaruh Konseling Obat terhadap Kepatuhan Pasien di Rumah Sakit Umum Pusat Adam Malik menggunakan Metode Pill Count. Jambura J Heal Sci Res 2023;5:342–3. DOI: https://doi.org/10.35971/jjhsr.v5i1.17428
Kuantitatif PP. Metode Penelitian Kunatitatif Kualitatif dan R&D. Alf Bandung 2016.
Notoatmodjo S. Metodologi penelitian kesehatan cetakan ketiga. Jakarta PT Rineka Cipta 2018.
Arikunto S. Prosedur Penelitian Suatu PendekatanPraktik Edis 2013.
Reddy D, Pulluru K. Principles of statistics & research methodology. Academic Guru Publishing House; 2024.
Lytras D, Bassfr SHS, Almrzouqi BB, Alsaywid BS. Principles of statistics in clinical trials. A Compr. Guid. Novice Res. Clin. Trials, Elsevier; 2026, p. 233–67. DOI: https://doi.org/10.1016/B978-0-443-27743-6.00007-5
Izah SC, Sylva L, Hait M. Cronbach’s alpha: A cornerstone in ensuring reliability and validity in environmental health assessment. ES Energy Environ 2023;23:1057. DOI: https://doi.org/10.30919/esee1057
Ho J, Bender BG, Gavin LA, O’Connor SL, Wamboldt MZ, Wamboldt FS. Relations among asthma knowledge, treatment adherence, and outcome. J Allergy Clin Immunol 2003;111:498–502. https://doi.org/10.1067/mai.2003.160. DOI: https://doi.org/10.1067/mai.2003.160
Gebresilassie TG, Worku A, Ahmed AA, Kabeta ND. Effect of asthma education intervention on self-management knowledge and control level in tigray, Northern ethiopia: a quasi experimental study. BMC Pulm Med 2025;25:120. DOI: https://doi.org/10.1186/s12890-025-03574-4
Beaurivage D, Boulet L-P, Foster JM, Gibson PG, McDonald VM. Validation of the patient-completed asthma knowledge questionnaire (PAKQ). J Asthma 2018;55:169–79. https://doi.org/10.1080/02770903.2017.1318914. DOI: https://doi.org/10.1080/02770903.2017.1318914
Levy ML, Bacharier LB, Bateman E, Boulet L-P, Brightling C, Buhl R, et al. Key recommendations for primary care from the 2022 Global Initiative for Asthma (GINA) update. NPJ Prim Care Respir Med 2023;33:7. DOI: https://doi.org/10.1038/s41533-023-00330-1
Arriazu-Ramos A, Santamaría JM, Monge-Barrio A, Bes-Rastrollo M, Gutierrez Gabriel S, Benito Frias N, et al. Health impacts of urban environmental parameters: a review of air pollution, heat, noise, green spaces and mobility. Sustainability 2025;17:4336. DOI: https://doi.org/10.3390/su17104336
Piracha A, Chaudhary MT. Urban air pollution, urban heat island and human health: a review of the literature. Sustainability 2022;14:9234.
Edeigba BA, Ashinze UK, Umoh AA, Biu PW, Daraojimba AI, Edeigba BA, et al. Urban green spaces and their impact on environmental health: A Global Review. World J Adv Res Rev 2024;21:917–27. DOI: https://doi.org/10.30574/wjarr.2024.21.2.0518
Piracha A, Chaudhary MT. Urban Air Pollution, Urban Heat Island and Human Health: A Review of the Literature. Sustainability 2022, 14, 9234 2022. DOI: https://doi.org/10.3390/su14159234
Kole TM, Muiser S, Kraft M, Siddiqui S, Fabbri LM, Rabe KF, et al. Sex differences in asthma control, lung function and exacerbations: the ATLANTIS study. BMJ Open Respir Res 2024;11. DOI: https://doi.org/10.1136/bmjresp-2024-002316
Muiser S, Kole TM, Kraft M, Siddiqui S, Fabbri LM, Rabe KF, et al. Sex Differences in Asthma Control, Lung Function and Exacerbations: The Atlantis Study. B99. ALL THAT WHEEZES Transl. Stud. ASTHMA, American Thoracic Society; 2023, p. A4249–A4249. DOI: https://doi.org/10.1164/ajrccm-conference.2023.207.1_MeetingAbstracts.A4249
Borrelli R, Brussino L, Lo Sardo L, Quinternetto A, Vitali I, Bagnasco D, et al. Sex-Based differences in asthma: Pathophysiology, hormonal Influence, and genetic mechanisms. Int J Mol Sci 2025;26:5288. DOI: https://doi.org/10.3390/ijms26115288
Agache I, Canelo‐Aybar C, Annesi‐Maesano I, Cecchi L, Biagioni B, Chung F, et al. The impact of indoor pollution on asthma‐related outcomes: a systematic review for the EAACI guidelines on environmental science for allergic diseases and asthma. Allergy 2024;79:1761–88. DOI: https://doi.org/10.1111/all.16195
Radbel J, Rebuli ME, Kipen H, Brigham E. Indoor air pollution and airway health. J Allergy Clin Immunol 2024;154:835–46. DOI: https://doi.org/10.1016/j.jaci.2024.08.013
Rahmawati R. Hubungan Antara Dukungan Keluarga Terhadap Tingkat Kepatuhan Pengobatan Pasien Penyakit Paru Obstruksi Kronis di RS Sari Asih Karawaci 2024.
Forshaw C, Poole K. Asthma and supported self-management. J Gen Pract Nurs 2025;11.
Kinley E, Pinnock H, Steed L, McClatchey K. Delivery of Supported Self‐Management in Primary Care Asthma Reviews: Insights From the IMP2ART Programme. Heal Expect 2024;27:e70100. DOI: https://doi.org/10.1111/hex.70100
Cipolle RJ, Strand L, Morley P. Pharmaceutical Care Practice: The Patient-Centered Approach to Medication Management, Third Edition. Mcgraw-hill; 2012.
Dayi F. Efektivitas Edukasi Pasien Dalam Pengendalian Penyakit Kronik di RSUD dr. Zainal Umar Sidiki. J Med Heal 2025;2:162–71.
Damiti SA, Farm S, Klin MF. Manajemen Terapi Obat: Perspektif Farmasi Klinis dan Komunitas. PT Bukuloka Literasi Bangsa; 2025.
Fitrianingsih S, Farm M. Farmasi Klinik dalam Pelayanan Kesehatan. PT Bukuloka Literasi Bangsa; 2025.
Puspitasari CE, Judijanto L, Liberitera S, Puspitaningrum AN, Oktavilantika DM, Lestari YE, et al. Dasar-Dasar Farmasi Klinis. PT. Sonpedia Publishing Indonesia; 2025.
Sari CP. Pengaruh Konseling Farmasis Terhadap Tingkat Kepatuhan dan Hasil Terapi Pasien Asma Rawat Jalan di Rumah Sakit Khusus Paru Respira UPKPM Yogyakarta 2013.
Amorha KC, Okonta MJ, Ukwe C V. Impact of pharmacist-led educational interventions on asthma control and adherence: single-blind, randomised clinical trial. Int J Clin Pharm 2021;43:689–97. DOI: https://doi.org/10.1007/s11096-020-01187-x
Asthma GI for. Global strategy for asthma management and prevention. Global Initiative for Asthma; 2025.
Monteiro C, Maricoto T, Prazeres F, Simoes PA, Simoes JA. Determining factors associated with inhaled therapy adherence on asthma and COPD: A systematic review and meta-analysis of the global literature. Respir Med 2022;191:106724. DOI: https://doi.org/10.1016/j.rmed.2021.106724
Rackow P, Drennan A, Pinnock H, Dima AL. Optimizing adherence to medication to improve outcomes in asthma. Curr Opin Pulm Med 2025;31:262–9. DOI: https://doi.org/10.1097/MCP.0000000000001166
El Abed H, Ragala MEA, Ait-taleb Lahsen H, Halim K. Impact of therapeutic education on asthma control, medication adherence, knowledge and quality of life in Moroccan adult asthma patients. Open Public Health J 2023;16. DOI: https://doi.org/10.2174/18749445-v16-230714-2023-121
Dipiro JT, Tee GC, Haines ST, Nolin TD, Ellingrod V., Posey LM. Dipiro’SPharmacotherapya Pathophysiologic Approach 12Th Edition. 2023.
Khairunnisa K, Heriyani F, Nurrasyidah I. Literature Review: Hubungan Tingkat Pengetahuan Asma dengan Tingkat Kontrol Asma. Homeostasis 2021;4:379–86.
Bridgeman MB, Wilken LA. Essential role of pharmacists in asthma care and management. J Pharm Pract 2021;34:149–62. DOI: https://doi.org/10.1177/0897190020927274
Armour C, Bosnic-Anticevich S, Brillant M, Burton D, Emmerton L, Krass I, et al. Pharmacy Asthma Care Program (PACP) improves outcomes for patients in the community. Thorax 2007;62:496–592. DOI: https://doi.org/10.1136/thx.2006.064709
Gordois A, Armour C, Brillant M, Bosnic-Anticevich S, Burton D, Emmerton L, et al. Cost-effectiveness analysis of a pharmacy asthma care program in Australia. Dis Manag Heal Outcomes 2007;15:387–96. DOI: https://doi.org/10.2165/00115677-200715060-00006
Al-Bahnasi TT, Basheti I. Investigating the value of medication management review for asthma patients: A randomized controlled study. Electron J Gen Med 2024;21. DOI: https://doi.org/10.29333/ejgm/14728
Basheti IA, Armour CL, Bosnic-Anticevich SZ, Reddel HK. Evaluation of a novel educational strategy, including inhaler-based reminder labels, to improve asthma inhaler technique. Patient Educ Couns 2008;72:26–33. DOI: https://doi.org/10.1016/j.pec.2008.01.014
Green LW, Kreuter MW. Health promotion planning: an educational and environmental approach. vol. 298. Mayfield publishing company Mountain View, CA; 1991.
Green LW, Kreuter MW. Health program planning: An educational and ecological approach. vol. 4. McGraw-Hill New York; 2005.
Sabaté E. Adherence to long-term therapies: evidence for action. World health organization; 2003.
Asyanti S. Manajemen Asma dalam Keluarga: Pendekatan Psikoedukatif. Deepublish; 2025.
Wahyuni AS. Perilaku Adherensi Pengobatan dan Kaitannya dengan Kualitas Hidup Pasien Asma di Kota Medan. KF Dr n.d.:97.
Wahyuni AS, Hamid RZ, Syafiuddin T, Bachtiar A, Nerdy N. The correlation between adherence and asthma patients quality of life in Medan, Indonesia. Open Access Maced J Med Sci 2018;6:2198. DOI: https://doi.org/10.3889/oamjms.2018.362
Rhee H, Belyea MJ, Brasch J. Family support and asthma outcomes in adolescents: barriers to adherence as a mediator. J Adolesc Heal 2010;47:472–8. DOI: https://doi.org/10.1016/j.jadohealth.2010.03.009