Effects of intervention on medication compliance in children with asthma

Na, Smith; Jp, Seale; Ley, P.; Shaw, John H.; Pu, Bracs

doi:10.5694/j.1326-5377.1986.tb112234.x

Cited by 56 publications

(15 citation statements)

References 8 publications

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“…The largest of these38 reported that behavioural management and education led to a significantly greater percentage of asthma medication doses taken (78.0±2.1%) compared to treatment as usual (54.5±2.9%). In another asthma cohort, adherence behaviours rated on a 4-point scale increased more in the intervention group (from 1.96±1.41 to 3.14±1.16) than control (1.96±1.35 to 2.14±1.37) 28…”

Section: Resultsmentioning

confidence: 99%

A systematic review of interventions to enhance medication adherence in children and adolescents with chronic illness

Dean

Walters²,

Hall³

2010

Archives of Disease in Childhood

173

132

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IntroductionPoor medication adherence is common in children and adolescents with chronic illness, but there is uncertainty about the best way to enhance medication adherence in this group. The authors conducted a systematic review of controlled trials examining interventions that aim to improve medication adherence. Method A comprehensive literature search was undertaken to locate controlled trials that described specifi c interventions aiming to improve adherence to long-term medication, where participants were aged 18 years and under, medication adherence was reported as an outcome measure, and which could be implemented by individual health practitioners. Studies were reviewed for quality and outcome. Results 17 studies met inclusion criteria: seven studies examined educational strategies, seven studies examined behavioural interventions and three studies examined educational intervention combined with other forms of psychological therapies. Only two of seven studies reported a clear benefi t for education on medication adherence, whereas four of seven trials indicated a benefi t of behavioural approaches on medication adherence. One trial reported that combining education with behavioural management may be more effective than education alone. Studies which combined education with other non-medication specifi c psychological interventions failed to demonstrate a benefi cial effect on medication adherence. Only two studies examined adherencepromoting interventions in young people with established adherence problems. Conclusion These fi ndings suggest that education interventions alone are insuffi cient to promote adherence in children and adolescents, and that incorporating a behavioural component to adherence interventions may increase potential effi cacy. Future research should examine interventions in high-risk groups. INTRODUCTIONAdherence has been defi ned as 'the extent to which a person's behaviour corresponds with agreed recommendations from a healthcare provider'. 1 Medication adherence refers to the degree to which the medications taken refl ect the prescriber's intention. 2 3 Poor medication adherence is common, especially in chronic illness, 1 3 4 and is associated with poorer outcomes. 3 5 6 Interventions to promote adherence may be effective, although benefi ts are not consistently demonstrated across studies. 4 A systematic review of interventions to enhance medication adherence in children and adolescents with chronic illness Angela J Dean, 1-3 Julie Walters, 4 Anthony Hall 4,5Most existing reviews of adherence-promoting interventions have focused on adults. However, many young people experience chronic illness 7 8 and poor medication adherence. 9-12 Involvement of families in medication routines, 12 13 and varying developmental capacities of children and adolescents 11 12 14 15 may infl uence medication adherence, reinforcing the need to identify interventions with demonstrated effi cacy in young people rather than translating fi ndings from adult research. 9 11 A review of interven...

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Section: Resultsmentioning

confidence: 99%

A systematic review of interventions to enhance medication adherence in children and adolescents with chronic illness

Dean

Walters²,

Hall³

2010

Archives of Disease in Childhood

173

132

View full text Add to dashboard Cite

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“…Published studies assessing the impact of intervention on medical compliance in asthmatic children have demonstrated a 1.3‐fold improvement in compliance with the introduction of an educational programme, 29 and a 1.8‐fold improvement with a combination of educational and behavioural strategies 30 . The 1.6‐fold improvement in compliance with technique (with the recommended four or more breath cycles per aerosol delivery), achieved with the introduction of the Funhaler device was comparable with these interventions.…”

Section: Discussionmentioning

confidence: 99%

A new asthma spacer device to improve compliance in children: a pilot study

et al. 2004

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“…In combination with behavioural strategies, written instructions help promote compliance to asthma treatment. [6][7][8] To ensure that the parents'/patients' understanding of their asthma treatment is adequate, the discharge coordinators generally attended each patient on more than one occasion (R Yeoh, discharge coordinator, personal communication). Repetition is an important technique for retention of medical knowledge, 9 but requires additional time spent with each patient.…”

Section: Discussionmentioning

confidence: 99%

Spacer compliance after discharge following a mild to moderate asthma attack

Cheng

Browne²,

Lam³

et al. 2002

Archives of Disease in Childhood

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Aim: To assess MDIS usage in patients discharged from a children's hospital emergency department following a mild to moderate asthma attack. Methods: Prospective observational study of 73 consecutive patients presenting to a children's hospital emergency department with a mild to moderate asthma attack. Demographic data, whether asthma literature/written MDIS instructions were provided, and who provided MDIS instructions (either a discharge coordinator or other emergency department staff) were noted. Parents of patients were telephoned after the first week following discharge and questioned about patient improvement, MDIS use/reasons for not using MDIS, and unscheduled presentations to their local doctor or hospital. Results: Following discharge, 50/73 (68.5%) patients used MDIS exclusively (compliers), while 23/73 used nebulisers some or all of the time (non-compliers). There was no difference in patient improvement or unscheduled presentations between compliers and non-compliers. Most non-compliers 14/23 (60.9%) changed because of parental preference; ease of nocturnal nebuliser use was a possible factor. Compliance was associated with the age of the patient, spacer usage at hospital, the size of device used at hospital, and whether an information fact sheet was given. Conclusions: Most children discharged from the emergency department following a mild to moderate asthma attack continue MDIS use exclusively in the first week. MDIS compliance may be associated with knowledge, experience, and ease of spacer usage. The study shows that education for parents is crucial for MDIS compliance.

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Effects of intervention on medication compliance in children with asthma

Cited by 56 publications

References 8 publications

A systematic review of interventions to enhance medication adherence in children and adolescents with chronic illness

A systematic review of interventions to enhance medication adherence in children and adolescents with chronic illness

A new asthma spacer device to improve compliance in children: a pilot study

Spacer compliance after discharge following a mild to moderate asthma attack

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