Related Experiment Videos
Suboptimal compliance to aerosol therapy in pediatric asthma: A prospective cohort study from Eastern India
Rajasree Sinha1, Sandeep Lahiry2, Sibarjun Ghosh1
1Department of Pediatrics, Medical College and Hospital, Kolkata, West Bengal, India.
Insights
Pediatric asthma patients in Eastern India show suboptimal compliance with aerosol therapy, with only 45.6% achieving good adherence. Factors like socioeconomic status and inhaler technique influence medication compliance.
Area of Science:
- Pediatric Pulmonology
- Respiratory Medicine
- Public Health
Background:
- Suboptimal adherence to aerosol medication is a significant challenge in managing pediatric asthma.
- Understanding noncompliance is crucial for improving treatment outcomes in children with asthma.
Purpose of the Study:
- To assess noncompliance rates to aerosol therapy in childhood asthma.
- To identify factors contributing to medication default in pediatric asthma patients.
Main Methods:
- A prospective cohort study involving 215 pediatric patients with mild to moderate asthma.
- Asthma diaries were used to track daily inhaler dosages, corroborated with unused medication.
- Medication compliance ratio (CR) calculated, with CR >80% defined as good compliance.
Main Results:
- Mean compliance was suboptimal at 75.3%, with 45.6% achieving good compliance.
- Higher socioeconomic status and proper inhaler technique correlated with better symptom control.
- Identified causes of noncompliance included fear of side effects, behavioral issues, and economic constraints.
Conclusions:
- Aerosol therapy compliance in pediatric asthma in Eastern India is suboptimal.
- Sociodemographic factors, disease severity, and inhaler technique are key determinants of compliance.
Background:
Suboptimal compliance to aerosol medication is common in pediatric asthma. Accordingly, the objective of this study is to assess noncompliance to aerosol therapy in childhood asthma and determine contributory factors.
Materials And Methods:
A prospective cohort study was conducted among pediatric patients attending asthma clinic. Patients (n = 215) having "mild" and "moderate" asthma severity rating were included. The total study duration was 12 months (June 2016-June 2017), with an active recruitment phase of 6 months. The minimum period for follow-up was 90 days. Caregivers were instructed to maintain an "asthma diary" for daily dosages of inhalers. At follow-up, the diary entries were corroborated with the amount of inhaler medication unused. Subsequently, medication compliance ratio (CR) was calculated according to the following formula: CR = number of medication doses taken/number of medication doses prescribed. CR% >80 was considered as "good compliance".
Results:
A total of 169 patients (78.6%) returned for follow-up. The mean compliance to asthma medication was suboptimal (75.3%). The children were primarily prescribed inhaled corticosteroids and short-acting beta-agonist (SABA)-based regimens on index visit. Leukotriene receptor antagonist was added in select cases (67.9%). Nearly 45.6% of the patients had "good compliance." CR correlated with the sociodemographic profile and disease severity. Higher socioeconomic status and proper inhaler technique reflected better symptom control. Fear of side effects, behavioral difficulties, and economic restrictions were the identified causes of medication default.
Conclusion:
In the Eastern part of India, compliance to aerosol therapy in pediatric asthma is suboptimal. Sociodemographics, disease severity, and inhaler technique are important determinants.