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What predicts poor collection of medication among children with asthma? A case-control study
L Irvine1, I K Crombie, E M Alder
1Dept of Epidemiology & Public Health, University of Dundee, Ninewells Hospital & Medical School, Dundee, UK. m.a.j.irvine@dundee.ac.uk
Insights
Poor adherence to asthma medication in children stems from parental perception of severity and effectiveness, not lack of knowledge. Establishing routines and providing support are key to improving medication collection and compliance.
Area of Science:
- Pediatric Pulmonology
- Behavioral Science
- Public Health
Background:
- Medication compliance is a significant challenge in managing childhood asthma.
- Successful asthma management relies on consistent adherence to prescribed prophylactic medication.
- Understanding factors influencing medication collection is crucial for improving treatment outcomes.
Purpose of the Study:
- To investigate factors predicting the irregular collection of prophylactic asthma medication in children.
- To identify differences between children with poorly controlled asthma who irregularly collect medication and those who adhere to collection schedules.
Main Methods:
- A case-control study design was employed.
- Cases included children with at least two consultations for poorly controlled asthma in one year and irregular prescription collection.
- Controls were children who collected their prescriptions as instructed.
Main Results:
- Knowledge about asthma and its medication was high in both groups.
- Parents of cases perceived their child's asthma as more severe and less controlled, reporting more symptoms and school absence.
- Parents of cases were less likely to integrate inhaler use into routines, perceived medication as less effective, and showed reluctance in administration.
Conclusions:
- Parental perception of asthma severity and medication effectiveness, alongside challenges in establishing routines, significantly impacts medication compliance.
- Lack of organized routines may contribute to poor compliance, potentially leading to undertreatment.
- Guidance on symptom interpretation and support in establishing administration routines are essential for parents.
Abstract:
Compliance with asthma medication is recognised to be a problem. Acquisition of medication is the first step towards compliance. Factors predicting poor collection of prophylactic medication were investigated. A case/control study was conducted. Cases were children who had had at least two consultations for poorly controlled asthma in 1 yr and collected prescriptions of prophylactic medication irregularly. Controls were children whose prescriptions were collected as instructed. Levels of knowledge about asthma and asthma medication were high in both groups. Parents of cases were more likely to perceive their child's asthma to be moderate or severe and more likely to report that their child's asthma was not well controlled. They reported more night-time symptoms, exercise symptoms and school absence. Parents of cases were less likely to report that administering inhalers was part of the evening routine. They were less likely to perceive their child's prophylactic medication to be very effective and more reluctant to administer prophylactic medication. Some parents may decide to undertreat their children, although lack of organised routine may contribute to poor compliance. Parents need guidance on interpreting symptoms and support in establishing routines for the administration of medication.
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