title: Adherence to montelukast versus inhaled corticosteroids in children with asthma.
abstract: Our objective was to compare adherence to montelukast with adherence to inhaled corticosteroids (ICS) in children with persistent asthma. In this retrospective study, we obtained data from a computerized hospital pharmacy database and medical records on 14l patients, 3-18 years of age, who received care for asthma at a military medical center. For each patient, we collected fill/refill data from a consecutive 6-month period and calculated an adherence rate, i.e., (# doses filled/# doses prescribed) x 100. We then determined whether the patient had "good adherence" (adherence rate, > or =70%) or "very poor adherence" (adherence rate, <50%). Eighty-one children were prescribed montelukast, and 104 took ICS; 44 of these children took both. The majority of patients had mild or moderate persistent asthma. There was no significant difference between mean adherence rates: 71% (95% CI, 65-77%) for montelukast vs. 67% (95% CI, 61-73%) for ICS. Fifty-one percent of patients taking montelukast had good adherence, compared to 41% in the ICS group (P = 0.27). Nineteen percent of the montelukast group and 26% of the ICS group had very poor adherence (P = 0.31). Using pharmacy refill data, we found that children with asthma were no more likely to take montelukast than inhaled corticosteroids. Adherence to both medications was suboptimal, even in a system that provides free and easy access to medications.
authors.affiliation: Department of Pediatrics, Madigan Army Medical Center, Tacoma, Washington, USA. edward.carter@seattlechildrens.org
authors.forename: Edward R
authors.initials: ER
authors.lastname: Carter
authors.forename: Madhu
authors.initials: M
authors.lastname: Ananthakrishnan
mesh_terms: D000085:Acetates / Q000627:therapeutic use*; D000730:Androstadienes / Q000627:therapeutic use; D001507:Beclomethasone / Q000627:therapeutic use; D001993:Bronchodilator Agents / Q000627:therapeutic use; D002648:Child; D003521:Cyclopropanes; D005260:Female; D000068298:Fluticasone; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D020024:Leukotriene Antagonists / Q000627:therapeutic use*; D008297:Male; D010349:Patient Compliance; D011804:Quinolines / Q000627:therapeutic use*; D012189:Retrospective Studies; D013440:Sulfides; D016896:Treatment Outcome; D014222:Triamcinolone Acetonide / Q000627:therapeutic use
chemical_list: D000085:Acetates; D000730:Androstadienes; D001993:Bronchodilator Agents; D003521:Cyclopropanes; D005938:Glucocorticoids; D020024:Leukotriene Antagonists; D011804:Quinolines; D013440:Sulfides; D000068298:Fluticasone; D014222:Triamcinolone Acetonide; D001507:Beclomethasone; C093875:montelukast