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True adherence with the Turbuhaler in young children with asthma

K Nikander1, M Turpeinen, A S Pelkonen

  • 1Department of Allergy, Helsinki University Hospital, Finland. kurt.nikander@philips.com

Archives of Disease in Childhood
|November 25, 2010
PubMed

Insights

True adherence to dry powder inhaler treatment for asthma in children declined significantly over 18 months, primarily due to decreased medication adherence, not inhaler technique. This impacts asthma management strategies.

Area of Science:

  • Pediatric Pulmonology
  • Respiratory Medicine
  • Asthma Management

Background:

  • Asthma affects millions of children globally, necessitating effective inhaler use for optimal treatment outcomes.
  • Dry powder inhalers (DPIs) like the Turbuhaler (TBH) are common for delivering inhaled corticosteroids.
  • True adherence combines medication use with correct inhaler technique, crucial for therapeutic success.

Purpose of the Study:

  • To evaluate true adherence to budesonide treatment using the Turbuhaler (TBH) in children with asthma over an 18-month period.
  • To differentiate the impact of medication adherence versus inhaler competence on overall treatment adherence.

Main Methods:

  • An 18-month prospective study involving 115 children (5-10 years) with asthma using budesonide via TBH.
  • Inhaler competence was assessed by measuring peak inspiratory flow through the TBH (PIF(TBH)) using electronic pneumotachography.
  • True adherence was calculated as the product of medication adherence (days with PIF(TBH) recordings) and inhaler competence (PIF(TBH) >40 L/min).

Main Results:

  • Mean true adherence decreased from 81.6% in the initial 45 days to 57.4% in the final 45 days.
  • Medication adherence declined from 86.0% to 59.3%, while inhaler competence remained high (94.7% to 96.2%).
  • The decline in true adherence was predominantly driven by reduced medication adherence, particularly in older children.

Conclusions:

  • True adherence to budesonide TBH treatment significantly decreased over the 18-month study due to declining medication adherence.
  • Inhaler competence with the budesonide TBH remained high and stable throughout the study period.
  • Findings highlight the need to address medication adherence challenges in pediatric asthma management.
Abstract

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