{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T19:51:04Z","timestamp":1773777064475,"version":"3.50.1"},"reference-count":38,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,12,17]],"date-time":"2025-12-17T00:00:00Z","timestamp":1765929600000},"content-version":"vor","delay-in-days":16,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100005743","name":"Universit\u00e0 Cattolica del Sacro Cuore","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100005743","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Curr Allergy Asthma Rep"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose of Review<\/jats:title>\n                    <jats:p>This scoping review aimed to explore psychological and related biopsychosocial factors influencing adherence to biologic therapies among individuals with asthma. Despite the proven efficacy of biologics for severe type 2 inflammation, real-world adherence remains variable. The review sought to identify individual, clinical, and contextual determinants that facilitate or hinder adherence behaviors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Recent Findings<\/jats:title>\n                    <jats:p>A systematic search of PubMed, Scopus, and APA PsycINFO identified 14 studies published between 2018 and 2025. Most were observational or retrospective and conducted in the United States. Adherence rates were generally moderate to high but varied across biologics. Systemic barriers included high out-of-pocket costs, complex insurance procedures, and limited access to specialist care. Clinically, patients with milder symptoms or low perceived treatment benefit were more likely to discontinue. Psychological barriers\u2014such as fear of injections, illness denial, depression, and stigma\u2014were recurrent yet understudied. Facilitators included perceived efficacy, emotional reassurance, shared decision-making, and supportive treatment settings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Summary<\/jats:title>\n                    <jats:p>Adherence to biologic therapies in asthma reflects a multidimensional interplay between systemic, clinical, and psychological influences. Integrating psychological assessment, patient education, and system-level support is essential to sustain long-term engagement. Future research should address psychological mechanisms and develop tailored interventions to enhance adherence and improve clinical outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s11882-025-01242-5","type":"journal-article","created":{"date-parts":[[2025,12,17]],"date-time":"2025-12-17T09:36:47Z","timestamp":1765964207000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Psychological and Related Factors Influencing Adherence to Biologic Therapies in Asthma: A Scoping Review"],"prefix":"10.1007","volume":"25","author":[{"given":"Valentina","family":"Poletti","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eleonora","family":"Volpato","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,12,17]]},"reference":[{"issue":"12","key":"1242_CR1","doi-asserted-by":"publisher","first-page":"958","DOI":"10.1038\/nrd3792","volume":"11","author":"G Pelaia","year":"2012","unstructured":"Pelaia G, Vatrella A, Maselli R. The potential of biologics for the treatment of asthma. Nat Rev Drug Discov. 2012;11(12):958\u201372. https:\/\/doi.org\/10.1038\/nrd3792.","journal-title":"Nat Rev Drug Discov"},{"key":"1242_CR2","doi-asserted-by":"publisher","unstructured":"McGregor MC, Krings JG, Nair P, Castro M. Role of biologics in asthma. AtsjournalsOrgMC McGregor, JG Krings, P Nair, M CastroAmerican J Respir Crit Care Med 2019. 2019;199:433\u201345.\u00a0atsjournalsOrg.\u00a0https:\/\/doi.org\/10.1164\/RCCM.201810-1944CI.","DOI":"10.1164\/RCCM.201810-1944CI"},{"key":"1242_CR3","doi-asserted-by":"publisher","first-page":"709","DOI":"10.1111\/RESP.14520","volume":"28","author":"P Ameen Shah","year":"2023","unstructured":"Ameen Shah P, Brightling C, Jenkins C, Bardin P. Biologics for severe asthma\u2014Which, when and why? Wiley Online Libr Shah, C Bright 2023. Wiley Online Libr. 2023;28:709\u201321. https:\/\/doi.org\/10.1111\/RESP.14520.","journal-title":"Wiley Online Libr"},{"key":"1242_CR4","doi-asserted-by":"publisher","first-page":"108","DOI":"10.1016\/J.JAIP.2017.06.008","volume":"6","author":"PP Hekking","year":"2018","unstructured":"Hekking PP, Amelink M, Wener RR, Bouvy ML, Bel EH. Comorbidities in difficult-to-control asthma. The Journal of Allergy and Clinical Immunology: In Practice. 2018;6:108\u201313. https:\/\/doi.org\/10.1016\/J.JAIP.2017.06.008.","journal-title":"The Journal of Allergy and Clinical Immunology: In Practice"},{"key":"1242_CR5","doi-asserted-by":"publisher","DOI":"10.1183\/16000617.0088-2024","author":"B Gyawali","year":"2025","unstructured":"Gyawali B, Georas SN, Khurana S. Biologics in severe asthma: a state-of-the-art review. Eur Respir Rev. 2025. https:\/\/doi.org\/10.1183\/16000617.0088-2024.","journal-title":"Eur Respir Rev"},{"key":"1242_CR6","doi-asserted-by":"publisher","first-page":"579","DOI":"10.1016\/J.ANAI.2021.07.010","volume":"127","author":"J Trevor","year":"2021","unstructured":"Trevor J, Lugogo N, Carr W, Moore WC, Soong W, Panettieri RA, et al. Severe asthma exacerbations in the United States: Incidence, characteristics, predictors, and effects of biologic treatments. Ann Allergy, Asthma Immunol. 2021;127:579-587.e1. https:\/\/doi.org\/10.1016\/J.ANAI.2021.07.010.","journal-title":"Ann Allergy, Asthma Immunol"},{"key":"1242_CR7","doi-asserted-by":"publisher","first-page":"3538","DOI":"10.1111\/ALL.15473","volume":"77","author":"G Varricchi","year":"2022","unstructured":"Varricchi G, Ferri S, Pepys J, Poto R, Spadaro G, Nappi E, et al. Biologics and airway remodeling in severe asthma. Allergy. 2022;77:3538\u201352. https:\/\/doi.org\/10.1111\/ALL.15473.","journal-title":"Allergy"},{"key":"1242_CR8","doi-asserted-by":"crossref","unstructured":"Darveaux J, Immunology WB-TJ of A and C, 2015 undefined. Biologics in asthma\u2014the next step toward personalized treatment. ElsevierJ Darveaux, WW BusseThe J Allergy Clin Immunol Pract 2015\u2022Elsevier n.d.","DOI":"10.1016\/j.jaip.2014.09.014"},{"key":"1242_CR9","doi-asserted-by":"crossref","unstructured":"Maddux J, Inselman J, Jeffery M, Chest RL. Adherence to asthma biologics: implications for patient selection, step therapy, and outcomes. 2021. Elsevier n.d.","DOI":"10.1016\/j.chest.2020.10.050"},{"key":"1242_CR10","doi-asserted-by":"publisher","DOI":"10.1111\/HEX.70285","author":"E Volpato","year":"2025","unstructured":"Volpato E, Poletti V, Banfi P, Bonanomi A, Pagnini F. Illness expectations and asthma symptoms: a 6-month longitudinal study. Health Expect. 2025. https:\/\/doi.org\/10.1111\/HEX.70285.","journal-title":"Health Expect"},{"key":"1242_CR11","doi-asserted-by":"crossref","unstructured":"Barton C, Clarke D, Sulaiman N, medicine MA-R. Coping as a mediator of psychosocial impediments to optimal management and control of asthma. 2003. Elsevier n.d.","DOI":"10.1016\/S0954-6111(03)00029-5"},{"key":"1242_CR12","doi-asserted-by":"crossref","unstructured":"Lavoie K, Bouthillier D, Bacon S, Lemi\u00e8re C, Chest JM. Psychologic distress and maladaptive coping styles in patients with severe vs moderate asthma. 2010. Elsevier n.d.","DOI":"10.1378\/chest.09-1979"},{"key":"1242_CR13","doi-asserted-by":"publisher","first-page":"410","DOI":"10.1016\/J.JAIP.2020.08.021","volume":"9","author":"IL Riley","year":"2021","unstructured":"Riley IL, Jackson B, Crabtree D, Riebl S, Que LG, Pleasants R, et al. A scoping review of international barriers to asthma medication adherence mapped to the theoretical domains framework. The Journal of Allergy and Clinical Immunology: In Practice. 2021;9:410-418.e4. https:\/\/doi.org\/10.1016\/J.JAIP.2020.08.021.","journal-title":"The Journal of Allergy and Clinical Immunology: In Practice"},{"key":"1242_CR14","doi-asserted-by":"publisher","first-page":"953","DOI":"10.11124\/JBIES-21-00242","volume":"20","author":"MDJ Peters","year":"2022","unstructured":"Peters MDJ, Godfrey C, McInerney P, Khalil H, Larsen P, Marnie C, et al. Best practice guidance and reporting items for the development of scoping review protocols. JBI Evid Synth. 2022;20:953\u201368. https:\/\/doi.org\/10.11124\/JBIES-21-00242.","journal-title":"JBI Evid Synth"},{"key":"1242_CR15","doi-asserted-by":"publisher","DOI":"10.1371\/JOURNAL.PONE.0278434","volume":"19","author":"SL Chan","year":"2024","unstructured":"Chan SL, Ho CZH, Khaing NEE, Ho E, Pong C, Guan JS, et al. Frameworks for measuring population health: a scoping review. PLoS One. 2024;19:e0278434. https:\/\/doi.org\/10.1371\/JOURNAL.PONE.0278434.","journal-title":"PLoS One"},{"key":"1242_CR16","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1080\/1364557032000119616","volume":"8","author":"H Arksey","year":"2005","unstructured":"Arksey H. Scoping studies: towards a methodological framework. Int J Soc Res Methodol. 2005;8:19\u201332. https:\/\/doi.org\/10.1080\/1364557032000119616.","journal-title":"Int J Soc Res Methodol"},{"key":"1242_CR17","doi-asserted-by":"crossref","unstructured":"McGowan J, Straus S, Moher D, EL-JC. Reporting scoping reviews-PRISMA ScR extension. Acad McGowan, S Straus, D Moher, EV Langlois, KK O\u2019Brien, T Horsley, A Aldcroft, W ZarinJ Clin Epidemiol. 2020. AcademiaEdu n.d.","DOI":"10.1016\/j.jclinepi.2020.03.016"},{"key":"1242_CR18","doi-asserted-by":"publisher","first-page":"492","DOI":"10.1093\/AJHP\/ZXAB392","volume":"79","author":"J Loucks","year":"2022","unstructured":"Loucks J, Zuckerman AD, Berni A, Saulles A, Thomas G, Alonzo A. Proportion of days covered as a measure of medication adherence. Am J Health-Syst Pharm. 2022;79:492\u20136. https:\/\/doi.org\/10.1093\/AJHP\/ZXAB392.","journal-title":"Am J Health-Syst Pharm"},{"key":"1242_CR19","doi-asserted-by":"crossref","unstructured":"Ledford D, Soong W, Carr W, Trevor J, LT-A of A. Real-world severe asthma biologic administration and adherence differs by biologic: CHRONICLE study results. 2023. Elsevier n.d.","DOI":"10.1016\/j.anai.2023.07.017"},{"key":"1242_CR20","doi-asserted-by":"crossref","unstructured":"Osazuwa-Peters O, Greiner M. AO-TJ of A. Factors related to biologic adherence and outcomes among moderate-to-severe asthma patients. 2022. Elsevier n.d.","DOI":"10.1016\/j.jaip.2022.05.022"},{"key":"1242_CR21","doi-asserted-by":"crossref","unstructured":"Bender B, Oppenheimer J, George M. RB-TJ of A, Assessment of real-world escalation to biologics in US patients with asthma. 2022. Elsevier n.d.","DOI":"10.1016\/j.jaip.2022.07.016"},{"key":"1242_CR22","doi-asserted-by":"crossref","unstructured":"Gleeson P, Morales K, Hvisdas C. AL-TJ of A, Factors associated with asthma biologic prescribing and primary adherence among adults in a large health system. 2023. Elsevier n.d.","DOI":"10.1164\/ajrccm-conference.2023.207.1_MeetingAbstracts.A6010"},{"key":"1242_CR23","unstructured":"Granda P, Villama\u00f1\u00e1n E, Carpio C. DL-F, Adherence to inhalers in patients with severe asthma treated with anti-interleukin-5 biologics. 2022. Elsevier n.d."},{"key":"1242_CR24","doi-asserted-by":"publisher","first-page":"63","DOI":"10.2147\/JAA.S328653","volume":"15","author":"AN Menzies-Gow","year":"2022","unstructured":"Menzies-Gow AN, McBrien C, Unni B, Porsbjerg CM, Al-Ahmad M, Ambrose CS, et al. Real world biologic use and switch patterns in severe asthma: data from the international severe asthma registry and the US CHRONICLE study. Taylor Fr. 2022;15:63\u201378. https:\/\/doi.org\/10.2147\/JAA.S328653.","journal-title":"Taylor Fr"},{"key":"1242_CR25","doi-asserted-by":"publisher","first-page":"1055","DOI":"10.2147\/JAA.S468068","volume":"17","author":"TT Le","year":"2024","unstructured":"Le TT, Price DB, Erhard C, Cook B, Quinton A, Katial R, et al. Disease burden and access to biologic therapy in patients with severe asthma, 2017\u20132022: an analysis of the international severe asthma registry. Taylor Fr. 2024;17:1055\u201369. https:\/\/doi.org\/10.2147\/JAA.S468068.","journal-title":"Taylor Fr."},{"key":"1242_CR26","doi-asserted-by":"crossref","unstructured":"Crimi C, Calabrese C, D\u2019Amato M. FB-EO. Patient and physician perspectives on biological treatment in severe asthma: a Severe Asthma Network Italy survey. 2023. PmcNcbiNlmNihGov n.d.","DOI":"10.1183\/23120541.00560-2023"},{"key":"1242_CR27","doi-asserted-by":"publisher","first-page":"549","DOI":"10.1016\/J.JAIP.2019.08.024","volume":"8","author":"JW Inselman","year":"2020","unstructured":"Inselman JW, Jeffery MM, Maddux JT, Shah ND, Rank MA. Trends and disparities in asthma biologic use in the United States. J Allergy Clin Immunol Pract. 2020;8:549-554.e1. https:\/\/doi.org\/10.1016\/J.JAIP.2019.08.024.","journal-title":"J Allergy Clin Immunol Pract"},{"key":"1242_CR28","doi-asserted-by":"publisher","first-page":"1839","DOI":"10.1080\/02770903.2021.1971700","volume":"59","author":"J Silver","year":"2022","unstructured":"Silver J, Bogart M, Molfino NA, Siddall J, Small M, Hanson M, et al. Factors leading to discontinuation of biologic therapy in patients with severe asthma. J Asthma. 2022;59:1839\u201349. https:\/\/doi.org\/10.1080\/02770903.2021.1971700.","journal-title":"J Asthma"},{"key":"1242_CR29","doi-asserted-by":"crossref","unstructured":"Corren J, Clinical RP-TJ of A and, undefined. How important is adherence to inhaled medications before starting a biologic therapy for asthma? 2018. Jaci-InpracticeOrg n.d.","DOI":"10.1016\/j.jaip.2018.07.007"},{"key":"1242_CR30","doi-asserted-by":"crossref","unstructured":"Stempel D, In SS-TJ of A and CI, undefined. Adding a biologic to asthma therapy: the role of adherence in selecting the right patient. 2022. Elsevier n.d.","DOI":"10.1016\/j.jaip.2022.08.034"},{"key":"1242_CR31","doi-asserted-by":"publisher","first-page":"1253","DOI":"10.2147\/PPA.S198953","volume":"13","author":"HL Gelhorn","year":"2019","unstructured":"Gelhorn HL, Balantac Z, Ambrose CS, Chung YN, Stone B. Patient and physician preferences for attributes of biologic medications for severe asthma. Patient Prefer Adherence. 2019;13:1253\u201368. https:\/\/doi.org\/10.2147\/PPA.S198953.","journal-title":"Patient Prefer Adherence"},{"key":"1242_CR32","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1007\/978-3-319-30994-1_2","volume-title":"Adherence in Dermatology","author":"I Aslam","year":"2016","unstructured":"Aslam I, Farhangian ME, Feldman SR. Models of Adherence. In: Adherence in Dermatology. 2016. p. 7\u201316. https:\/\/doi.org\/10.1007\/978-3-319-30994-1_2."},{"key":"1242_CR33","unstructured":"Christensen A. Patient adherence to medical treatment regimens: Bridging the gap between behavioral science and biomedicine. 2004."},{"key":"1242_CR34","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1016\/j.iac.2004.09.005","volume":"25","author":"BG Bender","year":"2005","unstructured":"Bender BG, Bender SE. Patient-identified barriers to asthma treatment adherence: responses to interviews, focus groups, and questionnaires. Immunol Allergy Clin North Am. 2005;25:107\u201330. https:\/\/doi.org\/10.1016\/j.iac.2004.09.005.","journal-title":"Immunol Allergy Clin North Am"},{"key":"1242_CR35","doi-asserted-by":"publisher","first-page":"543","DOI":"10.1080\/02770903.2016.1229335","volume":"54","author":"J Yorke","year":"2017","unstructured":"Yorke J, Adair P, Doyle AM, Dubrow-Marshall L, Fleming S, Holmes L, et al. A randomised controlled feasibility trial of group cognitive behavioural therapy for people with severe asthma. J Asthma. 2017;54:543\u201354. https:\/\/doi.org\/10.1080\/02770903.2016.1229335.","journal-title":"J Asthma"},{"key":"1242_CR36","doi-asserted-by":"crossref","unstructured":"Ambrosino N, Life PP-, 2021 undefined. Using telemedicine to monitor the patient with chronic respiratory failure. MdpiComN Ambrosino, P PierucciLife, 2021\u2022mdpiCom n.d.","DOI":"10.3390\/life11111113"},{"key":"1242_CR37","doi-asserted-by":"publisher","first-page":"1225","DOI":"10.2147\/PPA.S165404","volume":"12","author":"LL Zullig","year":"2018","unstructured":"Zullig LL, Blalock DV, Dougherty S, Henderson R, Ha CC, Oakes MM, et al. The new landscape of medication adherence improvement: where population health science meets precision medicine. Patient Prefer Adherence. 2018;12:1225\u201330. https:\/\/doi.org\/10.2147\/PPA.S165404.","journal-title":"Patient Prefer Adherence"},{"key":"1242_CR38","doi-asserted-by":"publisher","first-page":"353","DOI":"10.1093\/FAMPRA\/CMW122","volume":"34","author":"H Tapp","year":"2017","unstructured":"Tapp H, Derkowski D, Calvert M, Welch M, Spencer S. Patient perspectives on engagement in shared decision-making for asthma care. Fam Pract. 2017;34:353\u20137. https:\/\/doi.org\/10.1093\/FAMPRA\/CMW122.","journal-title":"Fam Pract"}],"container-title":["Current Allergy and Asthma Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11882-025-01242-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s11882-025-01242-5\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11882-025-01242-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,17]],"date-time":"2025-12-17T09:36:52Z","timestamp":1765964212000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s11882-025-01242-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12]]},"references-count":38,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2025,12]]}},"alternative-id":["1242"],"URL":"https:\/\/doi.org\/10.1007\/s11882-025-01242-5","relation":{},"ISSN":["1529-7322","1534-6315"],"issn-type":[{"value":"1529-7322","type":"print"},{"value":"1534-6315","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12]]},"assertion":[{"value":"26 July 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 December 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 December 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"<!--Emphasis Type='Bold' removed-->Ethics, Consent to Participate, and Consent to Publish"}},{"value":"The authors declare no competing interests.EV declares the winning of an ERS Long-Term Research Fellowship 2024 grant (ID Number: LTRF202404-01155), which is unrelated to this study. Therefore, the author(s) report no conflicts of interest related to this work.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"60"}}