Barriers in the management of childhood asthma: what care giver thinks about long term controller medication?

Dr Jaigam Abbas

doi:10.17511/ijpr.2017.i09.05

Abstract

Introduction: Asthma is the most common, chronic lower respiratory disease in childhood. Despite of the several guidelines and/or consensus documents available to support medical decisions to paediatric asthma; there are little updates available on the barriers’ to childhood asthma care among communities. Objectives: We aimed to determine social barriers to the management of childhood asthma. Methods: This was a qualitative, cross-sectional hospital based study in children aged between 1-15 years. Results: total 423 children with asthma were recruited from July 2014 to July 2016.out of them 126(29.78%) had mild intermittent, 190(44.91%) had mild persistent, 73(17.25%) had moderate persistent and 32(7.56%) had severe persistent asthma. In all persistent asthma cases long term controller medication was prescribed in which only 186(62.62%) accepted long term controller, while 111(37.37%) patients did not. Reasons for non-acceptance of long term controller medication in new cases were of financial constraints 25(22.52%), fear of dependency of controller medication 23(20.72%),fear ofside effect 17(15.31%), social stigma of inhalational device 15(13.51%), more preference to cough syrup 31(27.97%). Conclusion: A large numbers of barriers existed in the management of childhood asthma which has a bad impact on the patients and their families.

Highlights

Asthma is the most common, chronic lower respiratory disease in childhood.Despite of the several guidelines and/or consensus documents available to support medical decisions to paediatric asthma; there are little updates available on the barriers’ to childhood asthma care among communities
Pharmacotherapy for childhood asthma has been described in general asthma guidelines, including the recently updated Global Initiative for Asthma (GINA) guidelines [9]
A large gap exists between the latest treatment guidelines for many chronic diseases and the translation of these recommendations into everyday patient care [1011].Study from India by SS Salvi reported that only 36 % of asthmatic children used controller [12].In our study, we assessed barriers responsible for poor acceptability of controller medication in persistent asthma cases

Summary

Introduction

Asthma is the most common, chronic lower respiratory disease in childhood.Despite of the several guidelines and/or consensus documents available to support medical decisions to paediatric asthma; there are little updates available on the barriers’ to childhood asthma care among communities. Reasons fornon-acceptance of long term controller medication in new cases were of financial constraints 25(22.52%), fear of dependency of controller medication 23(20.72%),fear ofside effect 17(15.31%), social stigma of inhalational device 15(13.51%), more preference to cough syrup 31(27.97%).Conclusion: A large numbers of barriers existed in the management of childhood asthma which has a bad impact on the patients and their families. Various studies from India have been reported, prevalence ranging from 3.5% up to 29.5% [5].Childhood asthma presents as a substantial burden to the Manuscript received: 10th September 2017 Reviewed: 17th September 2017 Author Corrected: 23rd September 2017 Accepted for Publication: 30th September 2017 patient, their family and society. Despite of the international consensus on management of Asthma in childhood, many barriers exist, which may alter the course of the disease and adversely affect quality of life of the caregivers and their families

Objectives

Methods

Results

Discussion

Conclusion