CARE: An Observational Study of Adherence to Home Nebulizer Therapy Among Children with Asthma

Abstract

<jats:title>Abstract</jats:title> <jats:p><jats:bold>Background </jats:bold><jats:bold> </jats:bold>The prevalence of pediatric asthma in China is approximately 3%, and asthma remains poorly controlled in many of these patients. This study assessed the rate of adherence to home nebulizer treatment in pediatric patients in China.<jats:bold>Methods</jats:bold> The CARE study was a 12-week, multicentre, prospective, observational study across 12 tertiary hospitals in China. Patients were aged 0–14 years, clinically diagnosed with asthma and prescribed home nebulizer inhaled corticosteroid (ICS) therapy for ³ 3 months. The primary endpoint was electronically monitored treatment adherence. Patients attended onsite visits at 0, 4, 8 and 12 weeks to assess asthma control, severity and treatment adherence (recorded by electronic monitoring devices and caregivers).<jats:bold>Results</jats:bold><jats:bold> </jats:bold>The full analysis set included 510 patients. Median treatment adherence reported by electronic monitoring devices was 69.9%, and median caregiver-reported adherence was 77.9%. The proportion of patients with well-controlled asthma increased from 12.0% at baseline to 77.5% at Visit 4. Increased time between asthma diagnosis and study enrolment was a significant predictor for better adherence (coefficient: 0.01 [p = 0.0138, 95% confidence interval: 0.00, 0.01]) and asthma control (odds ratio = 1.001, p = 0.0498, 95% CI: 1.000, 1.002). Negative attitude to treatment by the caregiver was associated with poorer asthma control.<jats:bold>Conclusions</jats:bold>Adherence to home nebulization, a widely-used treatment for asthma, was high among Chinese pediatric patients. Asthma control improved with increasing treatment duration. These results suggest that home nebulization of ICS is an effective and recommendable long-term treatment for pediatric patients with asthma. <jats:bold>Trial registration</jats:bold>ClinicalTrials.gov, NCT03156998.</jats:p>

Adherence to inhaler technique among children with asthma

“…The result shows that ACT scores improved in all study arms with no significant differences between groups. A CIS can improve adherence to maintenance medication and reduce rescue medication use in patients with uncontrolled asthma [11] . An observational study was conducted on adherence to home nebulizer therapy among children with asthma; the study is to assess the rate of adherence to home nebulizer treatment in pediatric patients in China.…”