title: Providing feedback on adherence increases use of preventive medication by asthmatic children.
abstract: This study investigates the impact of measuring adherence and providing feedback on medication usage by children with unstable asthma. Adherence was measured using an electronic monitoring device. Subjects were randomized to either being told of their adherence during review consultations or for their adherence to remain undisclosed to their parents and treating physician. Subjects were reviewed monthly for 4 months. Twenty-six children aged between 6 and 14 years were recruited. Adherence was significantly higher in the intervention group (79% versus 58%, p <.01). There were significant improvements in clinical measures of disease control compared with baseline in both groups. The change in forced expiratory volume in 1 s (FEV(1)) (% predicted) was greater in those subjects receiving feedback (13.8% versus 9.8%). However, lung function values were lower in the intervention group at baseline and the relative improvement failed to reach statistical significance. Measuring adherence and providing feedback increases the use of preventive medication. A larger study is required to explore implications for disease control.
authors.affiliation: Department of Paediatrics, Redland Hospital, Brisbane, Queensland, 4163 Australia. st_burgess@bigpond.com
authors.forename: Scott W
authors.initials: SW
authors.lastname: Burgess
authors.forename: Peter D
authors.initials: PD
authors.lastname: Sly
authors.forename: Sunalene G
authors.initials: SG
authors.lastname: Devadason
mesh_terms: D000293:Adolescent; D000420:Albuterol / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000627:therapeutic use; D000730:Androstadienes / Q000008:administration & dosage / Q000627:therapeutic use; D001249:Asthma / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology / Q000523:psychology; D001993:Bronchodilator Agents / Q000008:administration & dosage / Q000627:therapeutic use; D002648:Child; D004338:Drug Combinations; D030141:Feedback, Psychological; D005260:Female; D000068298:Fluticasone; D000068297:Fluticasone-Salmeterol Drug Combination; D005541:Forced Expiratory Volume / Q000502:physiology; D006801:Humans; D008297:Male; D055118:Medication Adherence / Q000523:psychology*; D010353:Patient Education as Topic; D016896:Treatment Outcome; D016903:Drug Monitoring
chemical_list: D000730:Androstadienes; D001993:Bronchodilator Agents; D004338:Drug Combinations; D000068297:Fluticasone-Salmeterol Drug Combination; D000068298:Fluticasone; D000420:Albuterol