Skip to main content

Advertisement

SpringerLink
Log in

Pediatric asthma: a look at adherence from the patient and family perspective

  • Published:
Current Allergy and Asthma Reports Aims and scope Submit manuscript

Abstract

Although extensive research has been done in an effort to understand and promote adherence in pediatric asthma, little progress has been made in reducing the prevalence of nonadherence. Some researchers argue that a paradigm shift is necessary to advance the adherence field. Despite the recent trend for increasing the role of families in determining treatment plans, a patient-centered approach has been lacking in adherence to a daily regimen. It is clear that, although patients and families show evidence of inadvertent nonadherence (eg, forgetfulness), they also engage in volitional or intentional nonadherence, via reasoned and purposeful decisions. Patients conduct "experiments" with their regimen components in an effort to balance the burden of disease with the burden of treatment. These experiments typically involve some degree of nonadherence. Perhaps, if researchers strive to better understand the decision-making process involved in these experiments, health care providers can guide families in making adherence decisions that would lead to attainment of treatment goals, improvement in quality of life, and realization of positive clinical outcomes.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References and Recommended Reading

  1. Weinstein A: Asthma treatment and noncompliance. Del Med J 2000, 72:209–213.

    PubMed  CAS  Google Scholar 

  2. Milgrom H, Bender B: Nonadherence to asthma treatment and failure of therapy. Curr Opin Pediatr 1997, 9:590–595.

    Article  PubMed  CAS  Google Scholar 

  3. Deaton AV: Adaptive noncompliance in pediatric asthma: the parent as expert. J Pediatr Psychol 1985, 10:1–14.

    Article  PubMed  CAS  Google Scholar 

  4. Haynes RB, McDonald H, Garg AX, Montague P: Interventions for helping patients to follow prescriptions for medications. Cochrane Database Syst Rev 2004, 2:CD000011.

    Google Scholar 

  5. George M, Apter A: Improving adherence to asthma medications. Clin Pulm Med 2001, 8:257–264. s review article discusses the challenges to adherence that are medication-, disease-, patient-, and provider-specific, and subsequently suggests strategies to improve adherence based on their review of the literature in these areas.

    Article  Google Scholar 

  6. Mellins RB, Evans D, Zimmerman B, Clark NM: Patient compliance. Are we wasting our time and don’t know it? Am Rev Respir Dis 1992, 146:1376–1377.

    PubMed  CAS  Google Scholar 

  7. Cochrane MG, Bala MV, Downs KE, et al.: Inhaled corticosteroids for asthma therapy: patient compliance, devices, and inhalation technique. Chest 2000, 117:542–550.

    Article  PubMed  CAS  Google Scholar 

  8. McQuaid EL, Kopel SJ, Klein RB, Fritz GK: Medication adherence in pediatric asthma: reasoning, responsibility, and behavior. J Pediatr Psychol 2003, 28:323–333.

    Article  PubMed  Google Scholar 

  9. Rapoff MA: Adherence to Pediatric Medical Regimens. Dordrecht, Netherlands: Kluwer Academic Publishers; 1999.

    Google Scholar 

  10. Spector S: Noncompliance with asthma therapy: Are there solutions? J Asthma 2000, 37:381–388.

    PubMed  CAS  Google Scholar 

  11. Bauman LJ: A patient-centered approach to adherence: risks for nonadherence. In Promoting Adherence to Medical Treatment in Chronic Childhood Illness: Concepts, Methods, and Interventions. Edited by Drotar D. Mahwah, NJ: Lawrence Erlbaum; 2000:71–93. eview of the literature with respect to risks for nonadherence to pediatric medical regimens from a patient-centered approach. The author distinguishes and describes two types of nonadherence in the review.

    Google Scholar 

  12. Kuehni C, Frey U: Age-related differences in perceived asthma control in childhood: guidelines and reality. Eur Respir J 2002, 20:880–889.

    Article  PubMed  CAS  Google Scholar 

  13. Penza-Clyve SM, Mansell C, McQuaid EL: Why don’t children take their asthma medications? a qualitative analysis of children’s perspectives on adherence. J Asthma 2004, 41:189–197.

    Article  PubMed  Google Scholar 

  14. Hindi-Alexander MC, Throm J: Compliance or noncompliance: that is the question. Am J Health Promotion 1987, 1:5–11.

    Google Scholar 

  15. Wroe AL: Intentional and unintentional nonadherence: a study of decision making. J Behav Med 2002, 25:355–372.

    Article  PubMed  Google Scholar 

  16. Kelloway JS, Wyatt RA, Adlis SA: Comparison of patients’ compliance with prescribed oral and inhaled asthma medications. Arch Intern Med 1994, 154:1349–1352.

    Article  PubMed  CAS  Google Scholar 

  17. Lemanek KL, Kamps J, Chung NB: Empirically supported treatments in pediatric psychology: regimen adherence. J Pediatr Psychol 2001, 26:253–275.

    Article  PubMed  CAS  Google Scholar 

  18. Rubin DH, Bauman LJ, Lauby JL: The relationship between knowledge and reported behavior in childhood asthma. J Dev Behav Pediatr 1989, 10:307–312.

    Article  PubMed  CAS  Google Scholar 

  19. Weinstein A: Clinical management strategies to maintain drug compliance in asthmatic children. Ann Allergy Asthma Immunol 1995, 74:304–310.

    PubMed  CAS  Google Scholar 

  20. Riekert KA, Drotar D: Adherence to medical treatment in pediatric chronic illness: critical issues and answered questions. In Promoting Adherence to Medical Treatment in Chronic Childhood Illness: Concepts, Methods, and Interventions. Edited by Drotar D. Mahwah, NJ: Lawrence Erlbaum; 2000:3–32.

    Google Scholar 

  21. Buston KM, Wood SF: Non-compliance amongst adolescents with asthma: listening to what they tell us about selfmanagement. Family Pract 2000, 17:134–138.

    Article  CAS  Google Scholar 

  22. Weinstein A: Adherence. In Self-Management of Asthma. Edited by Kotses HE, Harver AE. New York: Marcel Dekker; 1998:329–378.

    Google Scholar 

  23. Creer TL: Self-management and the control of chronic pediatric illness. In Promoting Adherence to Medical Treatment in Chronic Childhood Illness: Concepts, Methods, and Interventions. Edited Drotar D. Mahwah, NJ: Lawrence Erlbaum; 2000:95–129.

    Google Scholar 

  24. Bennett P, Rowe A, Katz D: Reported adherence with preventive asthma medication. Psychol Health Med 1998, 3:347–354.

    Google Scholar 

  25. van Es SM, le Coq EM, Brownwert AI, et al.: Adherence-related behavior in adolescents with asthma: results from focus group interviews. J Asthma 1998, 35:637–646.

    PubMed  Google Scholar 

  26. Meng A, McConnell S: Decision-making in children with asthma and their parents. J Am Acad Nurse Pract 2002, 14:363–371. This empirical study described parent and child decision-making with respect to nonadherence to pediatric asthma regimens. They used verbatim transcripts of focus group interviews of school age children with asthma, who had attended an education-based asthma camp, and their parents.

    Article  PubMed  Google Scholar 

  27. Bender BG, Klinnert MD: Psychological correlates of asthma severity and treatment outcome in children. In Self-Management of Asthma. New York: Marcel Dekker; 1998:63–88.

    Google Scholar 

  28. Donovan JL: Patient decision making: the missing ingredient in compliance research. Int J Technol Assess Health Care 1995, 11:443–455.

    Article  PubMed  CAS  Google Scholar 

  29. Bender B, Wamboldt FS, O’Connor SL, et al.: Measurement of children’s asthma medication adherence by self report, mother report, canister weight, and doser CT. Ann Allergy Asthma Immunol 2000, 85:416–421.

    PubMed  CAS  Google Scholar 

  30. Riekert KA, Drotar D: The beliefs about medication scale: development, reliability, and validity. J Clin Psychol Med Settings 2002, 9:177–184.

    Article  Google Scholar 

  31. Horne R, Weinman J: Patients’ beliefs about prescribed medicines and their role in adherence to treatment in chronic physical illness. J Psychosom Res 1999, 47:555–567.

    Article  PubMed  CAS  Google Scholar 

  32. Goldman DP, Joyce GF, Escare JJ, et al.: Pharmacy benefits and the use of drugs by the chronically ill. JAMA 2004, 291:2344–2350.

    Article  PubMed  CAS  Google Scholar 

  33. Lim S, Goh DY, Tan AY, Lee BW: Parents’ perceptions towards their child’s use of inhaled medications for asthma therapy. J Paediatr Child Health 1996, 32:306–309.

    PubMed  CAS  Google Scholar 

  34. Drazen J, Boccuzzi SJ, Wogen J, et al.: Adherence to prescribed treatment for asthma (abstract). Am J Respir Crit Care Med 2000, 161:A402.

    Google Scholar 

  35. Balsbaugh TA, Chambers CV, Diamond JJ: Asthma controller medications: What do patients want? J Asthma 1999, 36:591–596.

    PubMed  CAS  Google Scholar 

  36. Bender BG: Overcoming barriers to nonadherence in asthma treatment. J Allergy Clin Immunol 2002, 109(6 Suppl):S554-S559.

    Article  PubMed  Google Scholar 

  37. Creer TL: Self-management of chronic illness. In Handbook of Self-Regulation. San Diego, CA: Academic Press; 2000:601–629.

    Google Scholar 

  38. Bender B, Milgrom H, Rand C: Nonadherence in asthmatic patients: Is there a solution to the problem? Ann Allergy Asthma Immunol 1997, 79:177–185; quiz 185–186.

    Article  PubMed  CAS  Google Scholar 

  39. Sewitch M, Abrahamowitz M, Barkun A, et al.: Patient nonadherence to medication in inflammatory bowel disease. Am J Gastroenterol 2003, 98:1535–1544.

    Article  PubMed  Google Scholar 

  40. Becker M, et al.: Patient perceptions and compliance: recent studies of the health belief model. In Compliance in Healthcare. Edited by Haynes R, Taylor D, Sackett DE. Baltimore, MD: Johns Hopkins University Press: 1979:78–109.

    Google Scholar 

  41. Bursch B, Schwankovsky L, Gilbert T, et al.: Construction and validation of four childhood asthma self-management scales: parent barriers, child and parent self-efficacy, and parent belief in treatment efficacy. J Asthma 1999, 36:115–128.

    PubMed  CAS  Google Scholar 

  42. Smith NA, et al.: Health benefits, satisfaction and compliance. Patient Educ Couns 1987, 10:279–286.

    Article  PubMed  CAS  Google Scholar 

  43. DePaola, L.M., et al.: Mothers’ and children’s perceptions of asthma medication. Child Health Care 1997, 26:265–283.

    Article  Google Scholar 

  44. Cassell EJ, Milbank Memorial Fund: Doctoring. In The Nature of Primary Care Medicine. New York: Oxford University Press: 1997.

    Google Scholar 

  45. Program, NAEPP: Highlights of the expert panel report: 2. In Guidelines for the Diagnosis and Management of Asthma. Washington, DC: U.S. Department of Health and Human Services; 1997.

    Google Scholar 

  46. Morris LS, Schulz RM: Medication compliance: the patient’s perspective. Clin Ther 1993, 15:593–606.

    PubMed  CAS  Google Scholar 

  47. Tousman S, Zeitz H: Motivating patients to change asthma medication adherence behavior. American Academy of Allergy Asthma & Immunology Nov, 2003. www.aaaai.org/members/ allied_health/articlesofinterest/motivating_patients.stm. Accessed March 17, 2004.

  48. Conrad P: The meaning of medications: another look at compliance. Soc Sci Med 1985, 20:29–37.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Developmental and Behavioral Sciences, Children’s Mercy Hospital, 2401 Gillham Road, 64108, Kansas City, MO, USA

    Christina D. Adams PhD, Meredith L. Dreyer MA, Chitra Dinakar MD & Jay M. Portnoy MD

Authors
  1. Christina D. Adams PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Meredith L. Dreyer MA
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Chitra Dinakar MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jay M. Portnoy MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Adams, C.D., Dreyer, M.L., Dinakar, C. et al. Pediatric asthma: a look at adherence from the patient and family perspective. Curr Allergy Asthma Rep 4, 425–432 (2004). https://doi.org/10.1007/s11882-004-0007-3

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11882-004-0007-3

Keywords

Search

Navigation