Latent profiles of illness and treatment perceptions and their associations with adherence and asthma control.

BACKGROUND

Asthma control remains suboptimal in a large proportion of patients, partly due to poor treatment adherence. Illness and treatment perceptions have been identified as key determinants of adherence and disease outcomes; however, their combined influence has been less frequently examined using person-centered approaches.

OBJECTIVE

To identify latent profiles of illness perceptions, treatment beliefs and adherence behaviors in Mexican adults with asthma, and to examine differences in asthma control across these profiles.

METHODS

A cross-sectional study was conducted with 264 adults with asthma. Latent profile analysis was performed using indicators of illness perceptions, treatment beliefs and adherence behaviors. Models were compared using AIC, BIC, entropy, BLRT and class size. Between-profile differences in asthma control and clinical variables were examined using nonparametric tests in R.

RESULTS

A three-profile solution was selected. Profile 1 showed intermediate levels across most indicators. Profile 2 was characterized by higher emotional representations, perceived consequences and treatment concerns, as well as lower illness coherence and lower adherence, and was associated with poorer asthma control. Profile 3 showed lower emotional burden, higher illness understanding, greater personal control, higher adherence and better asthma control. Significant differences were observed across profiles in asthma control, rescue inhaler use and emergency department visits, although effect sizes for clinical outcomes were small.

CONCLUSIONS

Distinct profiles were associated with differences in asthma control. Emotional representations and treatment concerns appear to play a central role in identifying patients at higher risk of poor adherence and suboptimal asthma control. These findings support the relevance of incorporating psychological assessment into asthma management and tailoring interventions according to patient profiles.