Bridging pharmacological complexity and psychosocial determinants of inhaler adherence in moderate-to-severe asthma: A cross-sectional analysis of key factors

Journal title PSICOLOGIA DELLA SALUTE
Author/s Dilara Usta, Caterina Bosio, Lorenza De Martinis, Alessio Piraino, Gherardo Siscaro, Simona Barbaglia, Filomena Bugliaro, Guendalina Graffigna
Online First 9/30/2026 Issue 2026/Online First
Language English Pages 21 P. 1-21 File size 297 KB
DOI 10.3280/pds2026-20460
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This cross-sectional study investigated the association between patient engagement and asthma control, treatment adherence, inhaler satisfaction, illness beliefs, and patient-pul-monologist interactions in adults with moderate-to-severe asthma. A sample of 103 Italian pa-tients completed an online survey including the Asthma Control Test, Test of Adherence to In-halers, Feeling of Satisfaction with Inhaler Questionnaire, Beliefs About Asthma Questionnaire, and Patient Health Engagement Scale, alongside ad-hoc items regarding patient-physician com-munication. Patient engagement levels were dichotomized, and group comparisons were con-ducted using Mann-Whitney U tests for continuous variables and Chi-square tests for categorical ones. Results showed that highly engaged patients had significantly better asthma control (U = 461.0, p < 0.001), perceived fewer illness consequences (U = 394.0, p < 0.001), and re-ported more collaborative relationships with their pulmonologists (p < 0.05). No significant dif-ferences were observed in adherence (U = 934.0, p = 0.382) or inhaler satisfaction (U = 847.0, p = 0.132) across engagement levels. These findings highlight patient engagement as a key psy-chosocial factor associated with improved asthma management and patient-clinician communi-cation. Future longitudinal research should examine how engagement trajectories influence health outcomes and identify interventions that integrate cognitive, emotional, and relational di-mensions to promote sustained asthma self-management.

Keywords: asthma, illness beliefs, inhaler satisfaction, patient engagement, self-management, treatment adherenc

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Dilara Usta, Caterina Bosio, Lorenza De Martinis, Alessio Piraino, Gherardo Siscaro, Simona Barbaglia, Filomena Bugliaro, Guendalina Graffigna, Bridging pharmacological complexity and psychosocial determinants of inhaler adherence in moderate-to-severe asthma: A cross-sectional analysis of key factors in "PSICOLOGIA DELLA SALUTE" Online First/2026, pp 1-21, DOI: 10.3280/pds2026-20460