Related Experiment Video
Updated: Apr 28, 2026
Noninvasive Sampling of Mucosal Lining Fluid for the Quantification of In Vivo Upper Airway Immune-mediator Levels
Published on: August 7, 2017
Adherence in childhood asthma: the elephant in the room
Robert W Morton1, Mark L Everard2, Heather E Elphick3
1University of Sheffield, Academic Unit of Child Health, Sheffield Children's Hospital, Sheffield, South Yorkshire, UK.
Insights
Many children with asthma struggle with inhaled steroid adherence, often below 75% even with electronic monitoring. This impacts disease control, with interventions showing limited success.
Area of Science:
- Pediatric Pulmonology
- Asthma Management
- Medication Adherence Research
Background:
- Suboptimal adherence to inhaled corticosteroids (ICS) is common in pediatric asthma, leading to poor disease control.
- Traditional adherence measurements in children are often subjective and lack accuracy.
- Objective electronic monitoring provides a more reliable assessment of adherence in pediatric asthma.
Purpose of the Study:
- To review studies utilizing electronic adherence monitoring in pediatric asthma.
- To quantify adherence rates and identify contributing factors to non-adherence.
- To evaluate the effectiveness of interventions aimed at improving adherence.
Main Methods:
- Systematic review of studies employing electronic adherence monitoring in children with asthma.
- Analysis of reported mean adherence rates from electronic monitoring data.
- Identification and categorization of reasons for intentional and non-intentional non-adherence.
- Review of intervention strategies and their reported success rates.
Main Results:
- Half of reviewed studies reported mean adherence rates of 50% or lower.
- The majority of studies indicated mean adherence rates below 75%.
- Non-adherence stems from a combination of illness perceptions, medication beliefs, and practical barriers.
- Interventions have shown limited success, with combined educational and behavioral approaches being most effective.
Conclusions:
- Electronic monitoring reveals widespread suboptimal adherence to inhaled steroids in pediatric asthma.
- Understanding multifaceted reasons for non-adherence is crucial for targeted interventions.
- Effective strategies for improving adherence require integrated educational and behavioral components.
Abstract:
Adherence to inhaled steroids is suboptimal in many children with asthma and can lead to poor disease control. Many previous studies in paediatric populations have used subjective and inaccurate adherence measurements, reducing their validity. Adherence studies now often use objective electronic monitoring, which can give us an accurate indication of the extent of non-adherence in children with asthma. A review of the studies using electronic adherence monitoring shows that half of them report mean adherence rates of 50% or below, and the majority report rates below 75%. Reasons for non-adherence are both intentional and non-intentional, incorporating illness perceptions, medication beliefs and practical adherence barriers. Interventions to improve adherence in the paediatric population have had limited success, with the most effective containing both educational and behavioural aspects.
Related Concept Videos
01:13Asthma III: Clinical Manifestations
01:28Asthma I: Introduction
01:24Asthma-III: Symptoms and Complications
Classification of Asthma
01:29Asthma-I: Introduction
01:26Asthma-II: Pathophysiology and Classification
Additionally, environmental and genetic factors play crucial roles in determining an individual's susceptibility to asthma and the severity of their condition.
Critical processes in asthma pathophysiology include:
01:20Asthma: Pathogenesis and Management
Asthma is classified as allergic and non-allergic. Allergens such as dust mites, pollen, and pet dander trigger allergic asthma, while factors like cold air, intense emotions, or exercise can induce non-allergic asthma.