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Intervention strategies for children poorly adherent with asthma medications; one center's experience

J M Sherman1, S Baumstein, L Hendeles

  • 1Department of Pediatrics, University of Florida College of Medicine, Gainesville 32610-0296, USA.

Clinical Pediatrics
|June 5, 2001
PubMed

Insights

Improving adherence to asthma treatment plans in children requires intensive interventions. Aggressive strategies like home nursing and medical neglect referrals significantly improved asthma control, unlike less intensive methods.

Area of Science:

  • Pediatric Pulmonology
  • Asthma Management
  • Treatment Adherence

Background:

  • Poor adherence to asthma treatment plans is prevalent in pediatric patients.
  • This non-adherence frequently leads to inadequate asthma control.
  • Effective interventions are crucial for improving pediatric asthma outcomes.

Purpose of the Study:

  • To evaluate the effectiveness of various interventions aimed at improving medication adherence and asthma control in pediatric patients.
  • To compare the impact of different levels of intervention intensity on treatment adherence and clinical outcomes.

Main Methods:

  • Implementation of multiple interventions: electronic monitoring of pulmonary function, behavior contracts, home nursing visits, and medical neglect reports.
  • Assessment of asthma control and adherence in selected pediatric patients undergoing these interventions.

Main Results:

  • The most aggressive interventions, specifically home nursing visits and medical neglect referrals, demonstrated improved outcomes.
  • Less aggressive measures, such as electronic monitoring and behavior contracts, did not yield significant improvements in adherence or asthma control.
  • A clear dose-response relationship was observed, with more intensive interventions showing greater efficacy.

Conclusions:

  • Intensive interventions, including home nursing and medical neglect referrals, are effective in improving adherence and asthma control in pediatric patients.
  • Less intensive strategies are insufficient for addressing poor adherence in this population.
  • Future asthma management strategies for children should consider the implementation of more robust, multi-faceted intervention approaches.

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