The Science Journal of the American Association for Respiratory Care

2003 OPEN FORUM Abstracts

The Impact of Inhaled Corticosteroid Therapy and Compliance on FEV1 in Asthmatic Children.

Erika Abmas RRT, RCP; Cheri Duncan RRT, RCP; Mary Hart RRT, RCP; Mark Millard M.D. Baylor University Medical Center, Dallas, TX.

Background:  The goal of asthma therapy is to achieve normal lung function and minimal respiratory symptoms with the first line of therapy for persistent asthma being an inhaled Corticosteroid (ICS). At a one-day asthma camp for children, we wanted to determine any correlation in baseline FEV1 between those on ICS therapy and those that were not, and whether parent or child perception of compliance to prescription therapy influenced baseline FEV1. METHOD: 43 asthmatic children 8-12 years age attended one-day asthma camps during the summer. These children were recruited through flyers sent to parents through the surrounding school districts and the media. As each child registered, they were asked to perform an FEV1 maneuver, using a KoKo Peak Pro. Registered Respiratory Therapists performed the test per American Thoracic Society guidelines. At registration, parents were asked to submit the child's medication regime and their opinion if prescribed anti-asthma medications were taken regularly by their children. At a later time, the children were asked the same question to see if there was a similarity in their response.

RESULTS: Parents identified 25 of 43 children attending camp as taking ICS. Normal FEV1 on ICS 15 (60%), abnormal FEV1 on ICS 10 (40%), normal FEV1 not on ICS 15 (83%), and abnormal FEV1 not on ICS 3 (17%). Parents estimated compliance to medication slightly higher than their children's: 32 yes/10 no, vs. children's estimation of 28 yes/14 no. In the group taking ICS with a normal FEV1, estimated compliance by parents was 10 yes/ 5 no, vs. children's 12 yes/ 3 no, and with an abnormal FEV1 estimated compliance by parents was 9 yes/ 1 no vs. children's 6 yes/ 4 no.

CONCLUSION: The goal of asthma therapy is to achieve normal lung function and minimal asthma symptoms. In this group of asthmatic children attending a one-day asthma camp, baseline abnormal lung function was identified in almost one-quarter; parent and children's estimation of compliance with ICS therapy differed slightly with children noting worse compliance.

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