Tensions surrounding the use of inhaled asthma medication in The Gambia: a qualitative study of asthma patients and health care workers

Abstract Introduction: Asthma-related mortality is high in low- and middle-income countries. Little is known about public perceptions of inhaled medicines. Methods: We conducted semi-structured interviews with asthma patients and health care workers at three public health facilities in The Gambia, between August and November 2022. Thematic analysis was used to interpret these data. Results: A total of 20 patients and 15 health care workers were interviewed. Both groups felt limited access to inhalers was a significant issue resulting in continued use of oral medications. While some patients recognised the benefits of inhaler use, beliefs that inhalers were dangerous were common. Reliance on oral short-acting beta agonists meant patients saw asthma as a recurrent acute condition resulting in an emphasis on hospital management with little awareness of inhaled preventative medicines. Discussion: Increasing access to inhaled medicines has the potential to save lives but socio-cultural factors in addition to medication supply need addressing.