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Children with Asthma Not Adhering to Emergency Steroid Prescriptions: Presented at AAP
By Maria Bishop
Special to DG News
BOSTON, MA -- October 23, 2002 -- A significant number of patients presenting to the emergency room (ER) with acute asthma are not adherent to their prescriptions for steroids, report researchers from Brookdale University Hospital and Medical Center, in Brooklyn, New York, United States.
Lead author Purushothaman Madhu, MD, presented the findings here October 22 at the annual meeting of the American Academy of Pediatrics (AAP).
Over a 9-week period, the researchers obtained contact information for 85 patients who were discharged from the pediatric emergency room (ER) of their institution with a prescription for oral prednisolone syrup or tablet (short-term burst therapy) for acute exacerbation of asthma. The patients' caretakers were contacted by telephone on the sixth day of the patient's ER visit, and information pertaining to the study was obtained through a questionnaire.
Of the 70 patient caretakers who were available for follow-up, 33 (47 percent) reported non-adherence to the steroid prescription.
Thirteen (39 percent) out of the 33 caretakers of non-adherent patients had no reason to offer when asked why the children did not adhere to the prescription; ten caretakers (30 percent) reported non-adherence due to reasons that could have been avoided through proper education about the benefit of steroids in acute asthma.
Six (16 percent) patients in the compliant group and two (6 percent) patients in the non-compliant group returned to ER with relapse within five days of the initial ER visit.
Twelve patient caretakers (32 percent) in the compliant group and nine patient caretakers (27 percent) in the non-compliant group had reached college level education.
Numerous studies have shown that using steroids to treat acute exacerbations of asthma will decrease the need for ER visits and hospitalisation, shorten the duration of symptoms and help reduce relapses.
Dr. Madhu concluded that, "Factors promoting this non-adherence need to be addressed."
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