The adherence to asthma medication for hospitalized children with asthma: A cross-sectional study in a tertiary hospital in Riyadh, Saudi Arabia
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Published on: February 3, 2023
Nawaf Abdullah Alghamdi1,2,3, Elaf A Alshammari1,2,3, Afnan A Alsahli1,2,3
1Department of Pediatric, King Abdullah Specialist Children's Hospital, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia.
Insights
Caregiver knowledge significantly impacts asthma control in children. Enhancing parental understanding of asthma is crucial for improving medication adherence and patient outcomes.
Area of Science:
- Pediatric Pulmonology
- Asthma Management
- Healthcare Education
Background:
- Asthma affects millions of children worldwide, necessitating effective management strategies.
- Controller therapy adherence and caregiver knowledge are critical for optimal asthma control.
- Understanding the relationship between caregiver knowledge and child's asthma control is essential for targeted interventions.
Purpose of the Study:
- To assess adherence to asthma controller therapy in admitted children.
- To identify factors influencing asthma control.
- To determine the association between caregiver asthma knowledge and asthma control.
Main Methods:
- A cross-sectional study involving 144 children (aged 2-14) admitted for asthma exacerbation.
- Caregivers were interviewed using the Asthma Knowledge Questionnaire and Pediatric Inhaler Adherence Questionnaire.
- Statistical analyses included descriptive statistics and odds ratios to determine associations.
Main Results:
- Caregiver asthma knowledge scores averaged 64%, with higher parental education linked to better knowledge.
- Metered dose inhaler (MDI) adherence was suboptimal, with median adherence score of 4.
- Children previously admitted were more likely to be nonadherent to MDI, and nonadherence was associated with poorer asthma control.
Conclusions:
- Low caregiver knowledge of asthma is associated with poor adherence to controller therapy.
- Improving parental knowledge is vital for enhancing medication adherence and achieving better asthma control in children.
- Targeted educational interventions for caregivers can improve asthma management and quality of life.
Aim:
The aim of the study was to assess adherence to asthma controller therapy and factors that influence asthma control and to determine the association between asthma knowledge of the caregiver and asthma control among admitted children with asthma.
Settings And Design:
A cross-sectional study was conducted between November 2022 and May 2023 in a tertiary care hospital. Children with a diagnosis of asthma aged 2-14 years, who were admitted to the hospital with an exacerbation of asthma were identified.
Methods:
Caregivers of the admitted children were interviewed using the Asthma Knowledge Questionnaire and Pediatric Inhaler Adherence Questionnaire.
Statistical Analysis Used:
Demographic and clinical data were described using descriptive analyses, where mean and standard deviation were used for normally distributed continuous variables, median and interquartile range (IQR), if otherwise. A P < 0.05 was set as a cutoff for statistical significance.
Results:
A total of 144 caregivers completed the survey. Median score for parents' knowledge of asthma was 64%, with an IQR of 59-67. Both mother's and father's educational levels were associated with a good level of knowledge: odds ratio (OR) = 2.48, 95% confidence interval (CI) = 1.1-5.6, and OR = 5.33, 95% CI = 2.23-12.7, respectively. Median adherence to metered dose inhaler (MDI) was 4 (IQR = 2-6). Children who had been admitted to the general ward in the last 6 months were three times more likely to be nonadherent to MDI (OR = 3.03, 95% CI = 1.18-7.82). Forty-three percent of children who were nonadherent to MDI were less likely to have their asthma controlled (OR = 0.43, 95% CI = 0.17-1.06).
Conclusion:
This study revealed that a low level of knowledge among caregivers of asthma patients is linked to inadequate adherence to asthma controller therapy. As medication adherence is crucial for achieving desirable asthma control and improving the quality of life for this population, efforts need to be made to enhance the knowledge level of parents of children with asthma.
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