ADHERENCE TO THERAPY AND ITS IMPACT ON THE CONTROL OF ASTHMA SYMPTOMS IN CHILDREN

Abstract

Objective: To assess the level of adherence to medical prescriptions and recommendations by patients with bronchial asthma (BA), in order to achieve control over the symptoms of the disease; to identify the most common factors of low adherence to BA therapy; to suggest strategies for optimizing treatment compliance. Methods: 92 children with a verified diagnosis of BA were examined. All patients underwent a general clinical, laboratory and instrumental examination, as well as an additional screening test with a mixture of respiratory allergens – the ImmunoCapPhadia® 250 method. The control of BA symptoms was assessed using ACT and ACQ tests. Adherence to BA therapy was assessed using a questionnaire. Results: Analysis of gender differences revealed that the proportion of male patients was 58%; female – 42%. The median age was 11 years. The average age of diagnosis of BA in children was 9 years. All patients were hospitalized during the period of exacerbation of the disease, the proportion of children with an attack of moderate BA – 87%; severe – 13%. An intermittent course of BA was observed in 28%; a persistent course in 72%. Analysis of ImmunoCap Phadia®250 data revealed that in 17.2% of cases class V sensitization prevailed, and the average values of allergen-specific IgE antibodies were 69.82 kU/L. Assessment of the level of control over asthma symptoms and the use of AST and ACQ tests revealed that partially controlled the course of BA was noted by 56% and uncontrolled over 46% of children. Analysis of the «Questionnaire of adherence to treatment of bronchial asthma (BA) in children», differences were found in the response to questions: «Do you experience difficulties in using the inhaler?» (χ2=8.952; p=0.003), «Was there any reluctance to take medications?» (χ2=4.715; p=0.03); «Does it happen that you forget to take drugs one/several days?» (χ2=5.093; p=0.025), «Are you satisfied with the prescribed therapy for BA?» (χ2=5.093; p=0.025). Conclusion: In order to achieve success in long-term control of the symptoms of BA in a patient, a comprehensive approach to the treatment and prevention of exacerbation of BA is required with an individual approach to each child, both from the doctor and from an adult who participates in the conduct and adherence to doctors appointments.

Keywords

• asthma
• children
• adherence
• compliance
• symptom control.