Aims

Algerian physicians report often difficulties securing patient compliance with inhaled therapies, occasionally experiencing outright refusal. The present study is the first investigation in North Africa to assess the prevalence and characteristics of patients showing inhaler treatment refusal and acceptance difficulty.

Methods

Data collection concerned all patients with an inhaler prescription on every Tuesday from September 2022 to January 2023 in 7 public and private health centers. The prescribing physician reported the Information on immediate acceptance, acceptance difficulty (defined as an initial refusal followed by acceptance after a physician?s effort of persuasion) or refusal.

Results

A total of 385 subjects were enrolled, revealing that 24.7% experienced difficulties accepting treatment initiation, while 8.3% refused it. Notably, parents of children younger than 2 years exhibited lower acceptance rates. In adults, non-acceptance was more frequent among younger individuals. Several variables such as gender, medical history, type of respiratory disease requiring treatment, care center ownership, social security coverage, geographic location, and socioeconomic status were not found to be associated with treatment acceptance. Inhalers containing long-acting bronchodilators were more commonly accepted. Fear of side effects was reported in 22.6%, fear of inhaler dependence 20.3%, and a belief that treatment was not necessary 2.6%. The fear of inhalers was reported to be fed by the immediate social circle 15.6 %, the extended social circle 5.7% and the media 1.8%.

Conclusion

Our study results suggest a considerable prevalence of inhalers acceptance difficulty in Algeria and highlight the importance of raising awareness.