Preschool children with high adherence to inhaled corticosteroids for asthma do not show behavioural problems


  • This study is part of a larger project on determinants of adherence to maintenance treatment in children with asthma, which is funded by the Netherlands Asthma Fund (grant number

Paul L.P. Brand, Princess Amalia Children’s Clinic, Isala klinieken, PO Box 10400, 8000 GK Zwolle, The Netherlands.
Tel: +31 38 4245050 |
Fax: +31 38 4247660 |


Aim:  To assess prevalence of behavioural problems in preschool children with asthma with electronically verified exposure to inhaled corticosteroids (ICS).

Methods:  Cross-sectional study of 81 children 2–5 years of age using daily ICS for persistent asthma. During 3 months’ follow-up, adherence to ICS treatment was recorded by an electronical logging device (Smartinhaler®). Parents completed the Child Behavior Checklist 1.5–5 years (CBCL 1.5–5) to assess behavioural problems; results were compared to a published reference group of healthy children.

Results:  The median (interquartile range) adherence to ICS was 92 (78–97) %. There was no difference in total CBCL score between children with asthma on ICS (mean, [SD] 32.10 [1.99]) and the reference group (33.30 [1.87], 95% CI for difference −6.62 to 4.22). Children with asthma were more likely to have somatic complaints (95% CI for difference 0.64 to 1.96) and less likely to have anxious/depressive symptoms (95% CI for difference −1.57 to −0.25) than the reference group. CBCL scores were not significantly related to the electronically measured adherence rates.

Conclusions:  Maintenance treatment with ICS, taken daily as prescribed, is not associated with an increased risk of behavioural problems in preschool children.