Uncontrolled asthma at age 8: The importance of parental perception towards medication

Authors

  • Ellen S. Koster,

    1. Division of Pharmacoepidemiology & Pharmacotherapy, Utrecht Institute for Pharmaceutical Sciences (UIPS), Faculty of Science, Utrecht University, Utrecht, The Netherlands
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  • Alet H. Wijga,

    1. Center for Prevention and Health Services Research, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
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  • Gerard H. Koppelman,

    1. Department of Paediatric Pulmonology and Paediatric Allergology, Beatrix Children’s Hospital, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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  • Dirkje S. Postma,

    1. Department of Pulmonology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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  • Bert Brunekreef,

    1. Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
    2. Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
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  • Johan C. De Jongste,

    1. Division of Paediatric Respiratory Medicine, Sophia Children’s Hospital, Erasmus Medical Center, Rotterdam, The Netherlands
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  • Henriette A. Smit,

    1. Department of Paediatric Pulmonology and Paediatric Allergology, Beatrix Children’s Hospital, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
    2. Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
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  • Maarten O. Hoekstra,

    1. Department of Paediatrics, St Radboud, University Medical Center Nijmegen, Nijmegen, The Netherlands
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  • Jan A. M. Raaijmakers,

    1. Division of Pharmacoepidemiology & Pharmacotherapy, Utrecht Institute for Pharmaceutical Sciences (UIPS), Faculty of Science, Utrecht University, Utrecht, The Netherlands
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  • Anke-Hilse Maitland-van der Zee

    1. Division of Pharmacoepidemiology & Pharmacotherapy, Utrecht Institute for Pharmaceutical Sciences (UIPS), Faculty of Science, Utrecht University, Utrecht, The Netherlands
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Anke-Hilse Maitland-van der Zee, Division of Pharmacoepidemiology & Pharmacotherapy, Faculty of Science, Utrecht University, PO Box 80082, 3508 TB Utrecht, The Netherlands
Tel.: +31 30 2534042
Fax: +31 30 2539166
E-mail: a.h.maitland@uu.nl

Abstract

To cite this article: Koster ES, Wijga AH, Koppelman GH, Postma DS, Brunekreef B, De Jongste JC, Smit HA, Hoekstra MO, Raaijmakers JAM, Maitland-van der Zee A-H. Uncontrolled asthma at age 8: The importance of parental perception towards medication. Pediatr Allergy Immunol 2011; 22: 462–468.

Abstract

Background:  Despite existing effective treatment options, asthma is uncontrolled in a considerable proportion of patients. The aim of this study was to identify determinants of uncontrolled asthma at age 8 in children participating in the PIAMA birth cohort study.

Methods:  One hundred seventy children using inhaled corticosteroids in the previous 12 months at age 8 were included. Uncontrolled asthma was defined as: ≥3 items present in the past month: (1) day-time or (2) night-time asthma symptoms, (3) limitations in activities, (4) rescue medication use, (5) FEV1 < 80% predicted and (6) unscheduled physician visits because of asthma. Binomial regression was performed to study five groups of determinants representing asthma control: child and parental characteristics, environmental factors, therapy adherence and parental perception towards medication use (Beliefs about Medicines Questionnaire).

Results:  Seventy seven children (45%) had uncontrolled asthma. Low maternal education (RR 1.6, 95% CI: 1.0–2.4) was associated with uncontrolled asthma. Parental necessity beliefs about medication use to maintain present and future health and parental concerns about potential adverse consequences of medication were also associated with uncontrolled asthma (RR 1.6, 95% CI: 1.1–2.2; and 1.6, 95% CI: 1.0–2.5, respectively).

Conclusions:  Environmental factors and therapy adherence were not associated with asthma control. In our cohort, uncontrolled asthma is associated with low maternal education and with strong parental beliefs about medication necessity and higher concern about potential side effects of medication.

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