Assessment of compliance in children using inhaled beta adrenergic agonists

The use of inhaled beta adrenergic agonists has assumed a greater role in the treatment of pediatric asthma as medications with a longer duration of action and more specificity for the beta 2 receptor have become available. Because of their effectiveness and safety, they are being selected as the drug of choice for maintenance therapy in children with asthma. The following study assessed compliance in asthmatic children using metaproterenol administered via a metered-dose inhaler (MDI) on a daily basis. Compliance was determined in 17 asthmatic children (aged 5 to 13 years) by measurement of cannister weight before and after a 2-week treatment period. Five children were studied for one 2-week period, while 12 children were studied for two consecutive 2-week periods. Two of five children (40%) completing 2 weeks were compliant, while only one of 12 children (8%) completing 4 weeks of the study was determined to be compliant as judged by changes in cannister weight during the treatment period. We conclude that despite the efficacy and safety of beta 2 adrenergic agonists administered via a MDI, poor compliance could potentially detract from their value as a maintenance medication in some asthmatic children.