CAH COMMENTS - 2nd WHO MODEL LIST OF ESSENTIAL MEDICINES FOR CHILDREN

Background: Parental attitudes towards the use of inhaled therapy in children with chronic asthma influencetreatment adherence and outcome. In the present study, we evaluated the perceptions and concerns of parentsof children with chronic asthma towards inhaled therapy.Methods: A self-administered standard questionnaire was distributed to parents of children attending thePaediatric Asthma Clinic. All these children required inhaled steroids for treatment.Results: One-hundred and twelve of 170 parents (66%) surveyed were concerned with inhaled therapy. Themost common concern with its use was medication side effects (91%), followed by ‘inhaler dependency’(86%), cost of the inhaler (34%) and difficulty in using the inhaler (15%). Parental perception that the oralroute was superior to the inhaled route, preference for the oral route for asthma prophylaxis and a highersteroid dose required for prophylaxis were more likely to be associated with concerns towards inhaledtherapy. More importantly, these children were also more likely to miss >25% of their prescribed doses ofinhaled steroids (46 vs 22% in the group concerned about inhaled therapy compared with the group that wasnot concerned, respectively; P=0.007) and had a higher mean number of nebulization treatments in the lastyear (3.2~2.9 vs 1.8~1.3 in the group concerned about inhaled therapy compared with the group that wasnot concerned, respectively; P=0.01).Conclusions: A significant proportion of parents whose children were on inhaled prophylaxis had concernstowards the use of inhaled therapy. Parental concern towards inhaled therapy appeared to increase theproblem of non-adherence to treatment. Education for these parents will need to be addressed to improveasthma management in our patient population.