Barriers to Inhaler Adherence in Asthmatic Children and Outcome After Intervention
Background: Poorly controlled asthma in children is often a consequence of non-compliance with inhaled corticosteroid (ICS) therapy. Several factors contribute to this non-compliance, including parental, social, and cultural prejudices and other factors. Objective: To study the barriers to adherence...
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| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2024-11-01
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| Series: | Medical Journal of Dr. D.Y. Patil Vidyapeeth |
| Subjects: | |
| Online Access: | https://journals.lww.com/10.4103/mjdrdypu.mjdrdypu_949_23 |
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| Summary: | Background:
Poorly controlled asthma in children is often a consequence of non-compliance with inhaled corticosteroid (ICS) therapy. Several factors contribute to this non-compliance, including parental, social, and cultural prejudices and other factors.
Objective:
To study the barriers to adherence to inhaler therapy and the effect of intervention in children with poor adherence to inhaler therapy.
Methodology:
The prospective observational study was conducted in a tertiary care hospital in Western Maharashtra after obtaining permission from the institutional ethics committee and written informed consent/assent. Sixty children aged 5–12 years with persistent asthma were enrolled and evaluated clinically by peak expiratory flow rate (PEFR). They were initiated on inhaler therapy, provided with asthma education and guidance, followed up with dose counting, and had repeated PEFR recordings to assess adherence and identify adverse factors affecting them.
Results:
Socio-demographic profiles revealed that three-fifths of asthmatic children belonged to middle socio-economic status, 81% were from nuclear families, and 70% reported unhygienic surroundings and poor quality of life. Analysis of barriers to adherence showed that perceptions of asthma as episodic, fear of side effects, media propaganda against inhalers, social stigma, complex treatment schedules, and forgetfulness were among the major impediments. The intervention program significantly improved adherence rates, with mean adherence increasing from 33.66% to 81.66%. The majority of participants transitioned from poor adherence to either fully or partially adherent categories, highlighting the effectiveness of the intervention.
Conclusion:
Daily ICS inhalers are highly effective in managing asthma symptoms and preventing exacerbations, but adherence remains a challenge. Personalized intervention programs focusing on asthma education and counseling can effectively overcome socio-familial barriers and improve adherence, thereby enhancing clinical outcomes. |
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| ISSN: | 2589-8302 2589-8310 |