'Chaotic' family life damages asthma adherence

GPs should talk to families about their domestic problems to tackle the reasons that prevent children using their asthma inhaler, researchers have said.

Asthma: chaotic family lives can undermine adherence to treatment (photo: SPL)
Asthma: chaotic family lives can undermine adherence to treatment (photo: SPL)

A Dutch study presented at the European Respiratory Society annual congress on Monday found children often failed to use their corticosteroid inhaler because a ‘chaotic’ home environment meant parents forgot to give them their medicine. Non-adherence can increase the risk of a severe exacerbation and hospitalisation.

Lead author Professor Paul Brand from the Princess Amalia Children’s Clinic in the Netherlands said: ‘It is crucial that healthcare professionals treating children with asthma carefully assess what these potential barriers could be so that appropriate interventions can be put in place to help correct the problems.’

He told GP that approaching asthma planning this way had changed the way he performed consultations: ‘I now start by asking: "What would you like to discuss with me today?" That brings up other issues during consultations. You can’t expect people just to follow your advice, you really need to show a genuine interest in what is important to them and drives them.’

Researchers interviewed the parents of 20 child asthmatics with high and low levels of adherence. Parenting and financial problems, a chaotic family life and being too busy were all given as factors why they forgot to give their child’s medicine each morning.

Children as young as 8 years old were given full responsibility for their medication without parent support, often leading to low adherence.

Some parents intentionally did not follow the doctor’s advice and instead adjusted the inhaled corticosteroid dose based on their own perception of their child’s asthma severity.

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