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Jing Zhang,1,2,* Chengchen Yin,1,3,4,* Hongfang Li,1,3,4 Weipeng Wei,1,3,4 Yuansha Gong,5 Fushan Tang1,3,4 1Department of Clinical Pharmacy, School of Pharmacy, Zunyi Medical University, Zunyi 563006, People’s Republic of China; 2Department of Respiratory Medicine, Central Hospital in Jinchang City (Worker’s Hospital of Jinchuan Group), Jinchang 737102, People’s Republic of China; 3The Key Laboratory of Clinical Pharmacy in Zunyi City, Zunyi Medical University, Zunyi 563006, People’s Republic of China; 4Key Laboratory of Basic Pharmacology of Ministry of Education and Joint International Research Laboratory of Ethnomedicine of Ministry of Education, Zunyi Medical University, Zunyi 563006, People’s Republic of China; 5School of Nursing, Zunyi Medical University, Zunyi 563006, People’s Republic of China*These authors contributed equally to this workCorrespondence: Fushan TangDepartment of Clinical Pharmacy School of Pharmacy, Zunyi Medical University, Zunyi 563006, People’s Republic of ChinaTel +86 851 2864 2337Fax +86 851 2864 2334Email fushantang@qq.comPurpose: Poor medication adherence can negatively affect health outcomes of patients with asthma from medication and significantly increase the healthcare costs. Management of adherence to inhalers remains a challenging topic in the long-term management of patients with asthma. We aim to evaluate the role of asthma control test (ACT) in the management of adherence to inhalers in outpatients with asthma.Patients and Methods: Six hundred twenty-seven outpatients with asthma admitted to the clinic of respiratory medicine in a tertiary hospital in northwestern China during 2016 to 2019 were randomly divided into observation group (n= 315) and control (n= 312) and received standard inhalant therapy for 6 months and lung function test before and after treatment. The patients in the observation group took ACT questionnaires at the end of each month, while the patients in control only took an ACT at the end of the last month. The ‘Test of Adherence to Inhalers’ (TAI) questionnaire was used to evaluate the patients’ adherence to inhalant therapy.Results: All patients completed the study. The ACT scores in the observation group showed a gradual increase month by month. The TAI results indicated that adherence to inhalers of patients in the observation group was significantly better than that in control and the patients’ non-adherence pattern in the observation group, with significantly lower erratic non-adherence, was also different from that in control. After 6 months of treatment, the lung function indexes and their relative improvement and the ACT scores in the observation group were significantly better or higher than those in control.Conclusion: The once-monthly self-reported ACT can effectively improve the adherence to inhalers of outpatients with asthma mainly by addressing erratic non-adherence and improve the treatment effects, and thus deserves widespread use in the treatment adherence management in patients with asthma.Keywords: asthma control test, ACT, medication adherence, Test of Adherence to Inhalers, TAI, self-management, China

Xingrui Mu,1– 3 Chengchen Yin,1– 3 Xing He,1– 3 Hongfang Li,1– 3 Yuansha Gong,4 Weipeng Wei,1– 3 Yan Zhang,1– 3 Fushan Tang1– 3 1Department of Clinical Pharmacy, School of Pharmacy, Zunyi Medical University, Zunyi 563006, People’s Republic of China; 2The Key Laboratory of Clinical Pharmacy in Zunyi City, Zunyi Medical University, Zunyi 563006, People’s Republic of China; 3Key Laboratory of Basic Pharmacology of Ministry of Education and Joint International Research Laboratory of Ethnomedicine of Ministry of Education, Zunyi Medical University, Zunyi 563006, People’s Republic of China; 4School of Nursing, Zunyi Medical University, Zunyi 563006, People’s Republic of ChinaCorrespondence: Fushan TangSchool of Pharmacy, Zunyi Medical University, Zunyi 563006, People’s Republic of ChinaTel +86 851 2864 2337Fax +86 851 2864 2334Email fstang@vip.163.comObjective: To investigate the correlation between patients’ medication adherence and their psychological contract with hospital pharmacists under the background of the pharmacist–patient relationship, providing a reference for improving the pharmacist–patient relationship and the patients’ medication adherence based on the patients’ psychological contract with the hospital pharmacists.Materials and Methods: Some of the patients who received medication dispensing service at the outpatient pharmacies at the First Affiliated Hospital of Zunyi Medical University and the Second Affiliated Hospital of Zunyi Medical University were included and investigated as follows: 320 patients were included through the convenient sampling method for psychological contract and medication adherence questionnaire survey with the self-designed scales for patients’ psychological contract with the hospital pharmacists and their medication adherence. SPSS 17.0 was used for reliability and validity testing, correlation analysis, and multiple linear regression analysis.Results: The average score of the psychological contract was 3.80± 0.59. The average score of the patients’ medication adherence was 2.93± 0.70. The patients’ psychological contract with the pharmacists and its dimensions (the responsibility of competence, the responsibility of service, and the responsibility of humanistic care) were positively correlated with medication adherence (P< 0.05). The results of the multiple linear regression analysis showed that the effect of patients’ psychological contract with the pharmacists on medication adherence was statistically significant (P< 0.05).Conclusion: Outpatients’ psychological contract with the pharmacists is positively correlated with their medication adherence. Maintaining the patients’ psychological contract with the pharmacists may be an effective way to improve medication adherence.Keywords: psychological contract, medication adherence, the relationship between pharmacists and patients