Medication use in uncontrolled pediatric asthma: results from the syspharmpedia study

Abstract

<b>Introduction:</b> Medication adherence has been previously linked to asthma control in the general asthma population, yet its association with asthma control in moderate to severe asthmatic children has been less explored. We aimed to investigate the risk of uncontrolled asthma related to treatment regimens, inhaler techniques, and medication adherence between children with controlled and uncontrolled moderate to severe asthma in the SysPharmPediA study. <b>Methods:</b> 145 Children with moderate to severe asthma (91 uncontrolled and 54 controlled) aged 6-17 were enrolled in this multicenter observational case-control study [Abdel-Aziz and Neerincx et al. JPM 2021]. A generalized linear model was fitted to compare variables and predict the risk of uncontrolled pediatric asthma. <b>Results:</b> The risk for uncontrolled asthma increased per GINA treatment step increase (OR (95%CI): 2.56 (1.15 - 5.81) and 10.27 (1.71 - 197.66) for step 4 and step 5, respectively. The medication adherence and inhaler techniques were not significantly associated with the risk of uncontrolled asthma. The odds ratio of uncontrolled asthma increased by the increase of change (Δ) between FEV₁% predicted post and pre salbutamol (OR (95%CI): 1.06 (1.00 - 1.14). <b>Conclusion:</b> Uncontrolled asthmatics were more likely to take add-on asthma medications and/or higher doses. Medication adherence and inhaler techniques did not explain the differences in asthma control in children. ΔFEV₁% pred was associated with the risk of uncontrolled pediatric asthma. This study suggests that uncontrolled asthma may be related to other underlying biological mechanisms in this moderate to severe asthmatic population.