Direct Observed Therapy of Inhaled Corticosteroids for Asthma at School or Daycare.

Content Provider	Europe PMC
Author	Pertzborn, Matthew C. Prabhakaran, Sreekala Hardy, Alicia Baker, Dawn Robinson, Matthew A. Hendeles, Leslie
Copyright Year	2018
Abstract	Background: Poor adherence with inhaled corticosteroid (ICS) medication is common in the pediatric population and can result in poor asthma control with increased frequency of asthma-related complications. The purpose of this study was to determine whether or not the initiation of ICS administration twice per day at school/daycare in patients with poor medication adherence at home improves asthma health care outcomes. Methods: We retrospectively selected patients followed by our Pediatric Pulmonology Clinic who had poorly controlled asthma and had been assigned to receive ICS twice daily at school/daycare due to poor adherence with ICS therapy. We analyzed the number of short courses of oral corticosteroids, hospital admissions, emergency department visits, and intramuscular methylprednisolone administrations for asthma exacerbations for the year before and after the intervention. The Wilcoxon signed rank test with continuity correction was used in the primary analysis. Results: Forty-nine patients who met the inclusion criteria were identified, but only 40 actually started the intervention. The number of oral corticosteroid courses per year decreased from 1.35 ± 1.1 before the intervention to 0.68 ± 1.2 (P = 0.008) postintervention, hospital admissions per year decreased from 0.45 ± 0.7 to 0.10 ± 0.3 (P = 0.006), emergency department visits per year decreased from 0.55 ± 0.8 to 0.28 ± 0.6 (P = 0.084), and intramuscular repository methylprednisolone injections per year for asthma exacerbations decreased from 0.20 ± 0.4 to 0.10 ± 0.3 (P = 0.23). Conclusion: These results indicate that school/daycare administration of ICS may be an effective option to improve indicators of asthma exacerbations in children with poor adherence to ICS at home.
Related Links	https://europepmc.org/backend/ptpmcrender.fcgi?accid=PMC6306660&blobtype=pdf
Page Count	4
ISSN	2151321X
Volume Number	31
DOI	10.1089/ped.2018.0912
PubMed Central reference number	PMC6306660
Issue Number	4
PubMed reference number	30595951
Journal	Pediatric Allergy, Immunology, and Pulmonology [Pediatr Allergy Immunol Pulmonol]
e-ISSN	21513228
Language	English
Publisher	Mary Ann Liebert, Inc., publishers
Publisher Date	2018-12-12
Publisher Place	USA
Access Restriction	Open
Rights License	Copyright 2018, Mary Ann Liebert, Inc., publishers
Subject Keyword	adherence pediatric asthma direct observed therapy inhaled corticosteroid therapy
Content Type	Text
Resource Type	Article
Subject	Pulmonary and Respiratory Medicine Immunology and Allergy Pediatrics, Perinatology and Child Health