[Factors influencing parental medication adherence in pediatric asthma].

PURPOSE: To identify the factors influencing parental medication control behaviors (inhaling corticosteroids and medication-taking) in pediatric asthma management. METHODS: A specially-designed questionnaire survey was conducted on 942 parents with asthmatic children in hospitals and elementary schools. RESULTS: Factor analysis on inhalation behaviors resulted in five factors: understanding of benefit, mastering on inhalation skills and medication management, family support, anxiety of side effects, and explanation from a doctor (cumulative contribution ratio=51.3%). Factor analysis on medication-taking behavior resulted in five factors: understanding of medication effectiveness and benefit, family support, anxiety of side effects, skills on giving medicines, and family routine (cumulative contribution ratio=50.6%). CONCLUSION: The results indicate the importance of recognizing factors influencing parental medication control behaviors in developing education strategies to maintain and reinforce their asthma management behaviors.

[Prospective observational study of clinical course after stopping inhaled corticosteroids in child asthma].

BACKGROUND: Prospective study was carried out to observe the clinical course and find out the clinical index to predict the outcome after stopping of inhaled corticosteroids (ICS). SUBJECTS: One hundred twelve asthmatic children (aged 12.9+/-9.6 years old) who were totally controlled with 100 microg/day of inhaled corticosteroids and have not experienced asthma symptom over 3 months, were enrolled. METHODS: Patients with over PC20 0.5 mg/mL of methacholine challenge test (MCT) were recommended to stop ICS therapy. Clinical course, lung function and bronchial hyperreactivity were followed at 7, 16 and 24 months after stopping of ICS. RESULTS: Eighty-one percent of 63 patients followed up to 24 months run on as symptom less than one time per month without remarkable change of lung function. PC20 in group of no asthma symptom during 24 months (group A) decreased weakly. That of other groups decreased remarkably. Days using ICS and plasma IgE antibody at stopping of ICS were different in clinical course at 24 months after stopping ICS. CONCLUSION: Over 80% of totally controlled asthmatic children with MCT PC20 over 0.5 mg/mL could stop ICS therapy and run on without relapse.