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Treatment compliance, passive smoking, and asthma control: a three year cohort study
1INSERM U408 Epidémiologie, Faculté de Médecine Xavier Bichat, B.P. 416, 75870 Paris Cedex 18, France. dsoussan@bichat.inserm.fr
Insights
Treatment compliance and avoiding parental smoking significantly improve asthma control in children. Adhering to prescribed medication and ensuring a smoke-free home are key for better health outcomes.
Area of Science:
- Pediatric Pulmonology
- Environmental Health
- Clinical Pharmacy
Background:
- Asthma is a common chronic respiratory disease in children.
- Effective asthma management relies on consistent treatment adherence and minimizing environmental triggers.
- Persistent asthma in children requires ongoing anti-inflammatory therapy.
Purpose of the Study:
- To investigate the impact of treatment compliance and parental smoking on asthma control in children with mild to moderate persistent asthma.
- To assess the relationship between adherence to inhaled anti-inflammatory treatment and symptom/peak expiratory flow control.
- To determine the influence of household smoking exposure on asthma control outcomes.
Main Methods:
- A prospective cohort study followed 167 children (aged 6-12 years) for three years.
- Asthma control was assessed using symptom frequency and peak expiratory flow (PEF) variability criteria.
- Data on treatment compliance and parental smoking habits were collected and analyzed.
Main Results:
- Only 25.1% of children achieved symptom control and 53.3% achieved PEF control.
- Higher treatment compliance was strongly associated with better symptom control (OR=4.82) and PEF control (OR=3.58).
- Smoking in the home significantly reduced the likelihood of achieving symptom control (OR=0.34) and PEF control (OR=0.34).
Conclusions:
- Improving treatment compliance through patient education is crucial for enhancing asthma control.
- Parental smoking cessation within the home is essential to improve asthma outcomes in children.
- Combined strategies focusing on adherence and smoke-free environments can maximize the benefits of asthma medication.
Aims:
To study the role of treatment compliance and parents' smoking on asthma control in children with recently diagnosed mild or moderate persistent asthma who were prescribed inhaled anti-inflammatory treatment.
Methods:
Prospective cohort study of 167 children aged 6-12 years (64% boys). Patients were examined at inclusion and followed up for three years with a visit every four months. Peak expiratory flow (PEF) was measured twice a day during the week before each visit. Two control criteria were monitored: (1) symptom control = having diurnal or nocturnal exacerbations less than once a week and no symptoms between exacerbations, at all visits; and (2) PEF control = daily PEF variability <20% on each of the seven days before each visit.
Results:
Symptom control was achieved by 25.1% of children and PEF control by 53.3%. Symptom control was positively related to having understood the way in which the medication worked and taking the prescribed doses (odds ratios (OR) = 3.38 and 4.82 respectively). It was inversely related to smoking within the home (OR = 0.34). PEF control was positively related to taking the prescribed doses (OR = 3.58). It was less frequently achieved if the mother smoked within the home (OR = 0.34).
Conclusions:
Results suggest that, to maximise the benefits of available asthma medication and to improve health outcomes, further efforts should be made to convince the parents of asthmatic children not to smoke in the house, and to improve compliance by increasing the patients' understanding of the disease and its treatment.