Inhaled Corticosteroids and Asthma Control in Children: Assessing Impairment and Risk

Rachelefsky, Gary S.

doi:10.1542/peds.2007-3273

Cited by 49 publications

(40 citation statements)

References 45 publications

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“…A escolha do desenho, controle histórico, mesmo com limitações, impôs-se frente às dificuldades de desenvolver um estudo de avaliação em uma cidade com a complexidade de Belo Horizonte, além de ser apontado por Gordis 14 hospitalização e de atendimentos de urgência como parâ-metros para avaliar tratamentos preventivos na asma 6,[16][17][18][19][20][21][22][23][24] . Por outro lado, essas variáveis são quantificáveis e também fatos marcantes na vida do paciente, reduzindo o viés de memória 25,26 .…”

Section: Discussionunclassified

Impact of an asthma management program on hospitalizations and emergency department visits

et al. 2011

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Objectives: To assess the frequency of hospitalizations and emergency department visits of children and adolescents before and after the enrolment in an asthma program.Methods: Medical records of 608 asthmatics younger than 15 years were assessed retrospectively. The frequency of hospitalizations and emergency department visits caused by exacerbations were evaluated before and after enrolment in an asthma program. Patients were treated with medications and a wide prophylactic management program based on the Global Initiative for Asthma (GINA). The before asthma program (BAP) period included 12 months before enrollment, whereas the after asthma program (AAP) period ranged from 12 to 56 months after enrollment. Results:In the BAP period, there were 895 hospitalizations and 5,375 emergency department visits, whereas in the AAP period, there were 180 and 713, respectively. This decrease was significant in all statistical analyses (p = 0.000). Conclusions:Compliance with the GINA recommendations led to a significant decrease in the frequency of hospitalizations and emergency department visits in children and adolescents with asthma.J Pediatr (Rio J). 2011;87(5):412-8: Asthma, hospitalisation, emergency medical services, continuing education, primary health care. ResumoObjetivo: Analisar as frequências de hospitalização e de atendimentos em serviços de urgência ocorridas em crianças e adolescentes antes e após o ingresso em programa de asma no Brasil. Métodos:Prontuários de 608 pacientes menores de 15 anos e com asma foram avaliados retrospectivamente. As frequências de hospitalização por asma e de atendimentos em serviços de urgência para episó-dios agudos de broncoespasmo foram avaliadas nos períodos anterior e posterior à admissão no programa que disponibiliza medicamentos, preconiza abordagem integral do paciente e manejo profilático de acordo com a Global Initiative for Asthma (GINA). O período de observação antes do programa (AP) teve a duração de 12 meses enquanto o depois do programa (DP) variou de 12 a 36 meses. Resultados:No período AP, ocorreram 895 hospitalizações e 5.375 atendimentos em serviços de urgência, e no período DP, ocorreram 180 hospitalizações e 713 atendimentos na urgência. O teste t de Student para amostras pareadas e o modelo de regressão para observações dependentes identificaram efeito significativo do programa em relação às variáveis estudadas (p = 0,000). Conclusões:A adoção das recomendações do GINA levou à redução significativa nas frequências de hospitalização e atendimentos na urgência em crianças e adolescentes com asma. J Pediatr (Rio J). 2011;87(5):412-8:Asma, hospitalização, atendimento de emergência, educação continuada, atenção básica à saúde. Impact of an asthma management program on hospitalizations and emergency department visitsImpacto de um programa de manejo da asma sobre as hospitalizações e os atendimentos de urgência IntroduçãoA asma, reconhecido problema de saúde pública, vem apresentando aumento na prevalência nas últimas décadas em algumas partes do mundo, ...

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Section: Discussionunclassified

Impact of an asthma management program on hospitalizations and emergency department visits

et al. 2011

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“…In a Dutch study [4], 55% of the children with doctor-diagnosed asthma had insufficient asthma control according to Global Initiative for Asthma (GINA) guidelines [5] in spite of the availability of effective maintenance therapy in the form of inhalation corticosteroids (ICS) [6]. This may be explained by poor adherence to ICS, which is on average ⩽50% [7,8].…”

Section: Introductionmentioning

confidence: 99%

e-Monitoring of Asthma Therapy to Improve Compliance in children (e-MATIC): a randomised controlled trial

Vasbinder

Goossens²,

Mölken³

et al. 2016

Eur Respir J

101

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Real-time medication monitoring (RTMM) is a promising tool for improving adherence to inhaled corticosteroids (ICS), but has not been sufficiently tested in children with asthma. We aimed to study the effects of RTMM with short message service (SMS) reminders on adherence to ICS, asthma control, asthma-specific quality of life and asthma exacerbation rate; and to study the associated cost-effectiveness.In a multicentre, randomised controlled trial, children (aged 4-11 years) using ICS were recruited from five outpatient clinics and were given an RTMM device for 12 months. The intervention group also received tailored SMS reminders, sent only when a dose was at risk of omission. Outcome measures were adherence to ICS (RTMM data), asthma control (childhood asthma control test questionnaire), quality of life (paediatric asthma quality of life questionnaire) and asthma exacerbations. Costs were calculated from a healthcare and societal perspective.We included 209 children. Mean adherence was higher in the intervention group: 69.3% versus 57.3% (difference 12.0%, 95% CI 6.7%-17.7%). No differences were found for asthma control, quality of life or asthma exacerbations. Costs were higher in the intervention group, but this difference was not statistically significant.RTMM with tailored SMS reminders improved adherence to ICS, but not asthma control, quality of life or exacerbations in children using ICS for asthma.

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“…[1][2][3][4][5] Persistent pediatric asthma can be controlled by modern medical treatment, including daily inhaled corticosteroid treatment to prevent airway inflammation. 6,7 However, rates of morbidity in pediatric asthma (e.g., problems in symptom control, activity limitations, and health care utilization) continue to rise, especially in minority populations. 8 One factor that has been consistently implicated in the high rates of pediatric asthma-related morbidity is nonadherence to recommended medical treatment.…”

mentioning

confidence: 99%

“…6 Studies have indicated that the asthma treatment regimen noted above can be effective in reducing symptoms, impairment, and health care utilization. 6,7 However, this treatment regimen is demanding in several respects: For example, it requires children and adolescents to take daily inhaled corticosteroid medication that may have side effects even when they do not have symptoms. Moreover, the treatment regimen requires parents and children to make difficult decisions such as when to use different quick relief medications to lessen acute symptoms and prevents emergency room visits and health care utilization.…”

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confidence: 99%

Influences on Adherence to Pediatric Asthma Treatment: A Review of Correlates and Predictors

Drotar

Bonner

2009

Journal of Developmental &Amp; Behavioral Pediatrics

144

141

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Nonadherence to treatment is an important influence on the health outcomes of children and adolescents with pediatric asthma, which is the most prevalent childhood chronic illness. Because the factors that influence treatment adherence for pediatric asthma are not well understood, a comprehensive review of relevant research is needed. To address this need, research concerning the correlates and predictors of adherence to inhaled corticosteroid treatment for pediatric asthma was reviewed. Significant predictors and correlates of treatment adherence identified in this review were consistent with a conceptual model that included family demographic characteristics and functioning, parent and child characteristics, health care system and provider characteristics, and child health outcomes. Family functioning and parental beliefs about asthma and medication treatment demonstrated consistent relationships with treatment adherence. Future research should test multivariate models of influences on treatment adherence in pediatric asthma in prospective studies using reliable and valid measures of predictors and outcomes. Intervention studies are also needed that target potentially modifiable, empirically supported influences to enhance treatment adherence. The clinical management of pediatric asthma would be enhanced by routine assessment of barriers to treatment adherence and anticipatory interventions that address them to prevent nonadherence.

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Inhaled Corticosteroids and Asthma Control in Children: Assessing Impairment and Risk

Cited by 49 publications

References 45 publications

Impact of an asthma management program on hospitalizations and emergency department visits

Impact of an asthma management program on hospitalizations and emergency department visits

e-Monitoring of Asthma Therapy to Improve Compliance in children (e-MATIC): a randomised controlled trial

Influences on Adherence to Pediatric Asthma Treatment: A Review of Correlates and Predictors

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