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Compliance with inhaled asthma medication in preschool children
N A Gibson1, A E Ferguson, T C Aitchison
1Department of Child Health, Royal Hospital for Sick Children, Glasgow, UK.
Insights
Parental supervision does not guarantee good compliance with asthma medication in preschool children. Studies show generally poor adherence to inhaled prophylactic therapy, impacting symptom control.
Area of Science:
- Pediatric Pulmonology
- Asthma Management
- Pharmacological Adherence
Background:
- Asthma medication compliance is a known issue in children and adults.
- Parental supervision is crucial for medication administration in preschool children.
- Limited data exists on compliance patterns and symptom control in this age group.
Purpose of the Study:
- To investigate compliance with inhaled prophylactic asthma therapy in preschool children.
- To explore the relationship between parental supervision, drug use patterns, and symptom control.
- To test the hypothesis that parental supervision leads to good compliance.
Main Methods:
- Observational study involving 29 asthmatic children (15 months to 5 years).
- Utilized electronic inhaler timer devices to track medication actuation.
- Employed diary cards for recording symptoms and parent-reported compliance.
Main Results:
- Demonstrated variable and generally poor compliance, with a median of 50% of study days showing full adherence.
- Overall median adherence was 77% of prescribed doses.
- Daycare attendance was linked to poorer compliance; no correlation found between compliance and symptom control.
Conclusions:
- Compliance with inhaled prophylactic asthma therapy remains poor in preschool children, even with parental supervision.
- Parental supervision alone does not ensure adequate adherence to asthma medication.
- Further strategies are needed to improve medication adherence in young asthmatic children.
Background:
Previous studies have shown poor compliance with regular drug therapy in children and adults with asthma. In preschool children the parents supervise and are responsible for drug administration, but little is known of compliance in this group. In addition, there are few data on the patterns of drug use of inhaled prophylactic asthma therapy or of the relation between compliance and symptom control. A study was undertaken to address these issues with the hypothesis that parental supervision would result in good compliance.
Methods:
The subjects were 29 asthmatic children aged 15 months to five years already established on inhaled prophylactic medication delivered through a large volume spacer. The prescribed drug regimens varied between subjects. This was an observational study using an electronic inhaler timer device to record the date and time of each actuation of the aerosol canister. Diary cards were used for parallel recording of symptoms and parentally reported compliance with a drug regimen.
Results:
Variable and generally poor compliance was demonstrated with a median of 50% of study days with full compliance (subject range 0-94%) and an overall median of 77% of prescribed doses of therapy taken during the study period. No relation was found between frequency of prescribed regimen and good compliance. Day care was associated with poorer compliance. No relation between good compliance and low symptom scores was found.
Conclusion:
Compliance with inhaled prophylactic therapy is poor in preschool children with asthma whose medication is administered under parental supervision.