Children's adherence to recommended asthma self-management.

Area of Science:

• Pediatric Pulmonology
• Behavioral Science in Medicine
• Asthma Management

Background:

• Asthma affects millions of children, with adherence to monitoring crucial for management.
• Peak expiratory flow rate (PEFR) monitoring is a key tool for asthma self-management.
• Declining adherence to daily monitoring can lead to poor asthma control and increased morbidity.

Purpose of the Study:

• To evaluate adherence to peak expiratory flow rate (PEFR) monitoring in children with asthma.
• To test a behavioral strategy, contingency management, aimed at enhancing daily PEFR monitoring adherence.

Main Methods:

• A 5-week randomized controlled trial involving 42 children (7-11 years) with persistent asthma.
• Electronic data collection via PeakLog and self-report using the Asthma Diary.
• Comparison of adherence rates between an intervention group and a usual care group.

Main Results:

• Adherence to PEFR monitoring demonstrated a decline over the 5-week study period.
• The intervention group showed higher median adherence (79%) at week 5 compared to the usual care group (64%).
• While not statistically significant, the observed difference and effect size suggest a potential benefit of the behavioral strategy.

Conclusions:

• Even modest improvements in adherence to asthma treatment regimens can be clinically significant.
• Contingency management presents a promising behavioral approach for improving adherence to asthma monitoring.
• Future research should utilize larger sample sizes and more intensive behavioral strategy training to confirm these findings.