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[Persistence rate for clinic visit in children with asthma after initiating controller therapy]
Michiaki Hayashida1, Norihide Murayama, Kyoichiro Toyoshima
1Hayashida Clinic.
Insights
Clinic visit adherence declines over time in children with asthma on controller medication, particularly in older children and those with severe asthma. Strategies are needed to improve patient follow-up for better asthma management.
Area of Science:
- Pediatric Pulmonology
- Asthma Management
- Clinical Adherence Research
Context:
- Asthma management in children requires consistent medical follow-up.
- Controller medications are crucial for managing persistent asthma in pediatric populations.
- Adherence to regular clinic visits is a key factor in effective long-term asthma care.
Purpose:
- To assess the persistence rate of clinic visits in children with asthma prescribed controller medication.
- To identify age-related and severity-related patterns in clinic visit adherence.
- To evaluate the decline in follow-up rates over a 180-day period.
Summary:
- A study of 73 children with asthma found a significant decrease in clinic visit persistence over 180 days.
- Adherence was lower in children aged 6-15 years and those with moderate to severe persistent asthma compared to younger or mildly affected children.
- The mean persistence rate dropped from 90.4% at 30 days to 38.4% at 180 days.
Impact:
- Findings highlight a critical gap in continuous care for pediatric asthma patients.
- Identifies specific subgroups (older children, severe asthma) at higher risk for poor adherence.
- Emphasizes the need for targeted interventions to improve follow-up and optimize asthma control in children.
Object:
To investigate the actual condition of the persistence rate for clinic visit in children with asthma requiring controller medication.
Methods:
Seventy-three asthma children (0 to 15 years of age) who initiated controller medication were enrolled this study. Patients and their parents were educated about this disease (mechanism of asthma, airway inflammation, and necessity of asthma medication) and instructed to visit clinics regularly every 30 days. We prospectively monitored visit rate of the patients for 180 days.
Results:
Mean persistence rate for clinic visit of all patients was gradually decreased, 90.4% on the 30 day, 82.2% on the 60 day, 78.1% on the 90 day, 67.1% on the 120 day and 38.4% on the 180 day, respectively. The persistence rate on the 180 day of 2 to 5 years old patients was significantly lower than that of < 2 years old patients and the rate on the 60 days or more after in 6 to 15 years old patients was lower than that of < 2 years old patients. It was also significantly lower in patients with moderate and severe persistent asthma than in mild persistent patients.
Conclusion:
Despite of the investigation in the setting of asthma specialty clinic, the persistence rate for clinic visit was decreased with time, especially in 6 to 15 years old or moderate to severe asthmatic patients. In order to improve the situation, it is necessary to analyze the cause of poor adherence and make a concrete action plan.
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