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Compliance with therapy in children with respiratory diseases
M H Schöni1, E Horak, W H Nikolaizik
1Alpine Children's Hospital Davos, Davos Platz, Switzerland.
Insights
Patient adherence to respiratory medication is low, with only 47.6% compliance observed. Inadequate theophylline dosages, often due to physician prescribing errors, further compromise treatment effectiveness in children and adolescents.
Area of Science:
- Pediatric Pulmonology
- Clinical Pharmacology
Background:
- Asthma and other respiratory diseases are common in children and adolescents.
- Effective management relies on consistent adherence to prescribed medical treatments.
- Assessing true medication compliance in pediatric populations presents significant challenges.
Purpose of the Study:
- To evaluate medical treatment compliance in pediatric patients with respiratory diseases.
- To compare the effectiveness of different assessment methods for compliance.
- To identify factors influencing medication adherence in this demographic.
Main Methods:
- Utilized a double-blinded, covert recording of air compressor use for nebulization.
- Determined serum theophylline levels as a biochemical marker of compliance.
- Conducted an open, randomized trial for theophylline dosage assessment.
Main Results:
- Covert monitoring revealed an overall medication compliance rate of 47.6%.
- In the theophylline trial, 56%-71% of patients had sub-therapeutic serum levels (10-20 mg/l).
- Physicians prescribed doses below recommended levels in 72% of cases, contributing to low serum concentrations.
Conclusions:
- Medication compliance is multifactorial, influenced by patient adherence.
- Drug efficacy and physician prescribing practices significantly impact treatment outcomes.
- Improved physician education on appropriate dosing is crucial for pediatric respiratory care.
Abstract:
Compliance with medical treatment was evaluated in 89 children and adolescents with respiratory diseases using two methods of assessment: a double blinded covert recording of the use of an air compressor for nebulization of drugs and the determination of theophylline levels in serum. In the covert monitoring of inhalation the overall compliance with the prescribed medication was 47.6%. In the open randomized theophylline trial, 56%-71% of the patients (according to uncontrolled or controlled intake of the drug) received a dosage of theophylline which was too low to achieve a sufficient serum level in the range of 10-20 mg/l. This, however, was also due to the fact that in 72% of the cases physicians prescribed doses which were substantially below the recommended amount of drug according to age and weight. It is, therefore, concluded that compliance of medication is based on the patients adherence to the medication, to the efficacy of the drug itself and the attitude of the physician.