title: Uncontrolled asthma at age 8: the importance of parental perception towards medication.
abstract: BACKGROUND
  Despite existing effective treatment options, asthma is uncontrolled in a considerable proportion of patients. The aim of this study was to identify determinants of uncontrolled asthma at age 8 in children participating in the PIAMA birth cohort study.
  
  
  METHODS
  One hundred seventy children using inhaled corticosteroids in the previous 12 months at age 8 were included. Uncontrolled asthma was defined as: ≥3 items present in the past month: (1) day-time or (2) night-time asthma symptoms, (3) limitations in activities, (4) rescue medication use, (5) FEV(1) <0% predicted and (6) unscheduled physician visits because of asthma. Binomial regression was performed to study five groups of determinants representing asthma control: child and parental characteristics, environmental factors, therapy adherence and parental perception towards medication use (Beliefs about Medicines Questionnaire).
  
  
  RESULTS
  Seventy seven children (45%) had uncontrolled asthma. Low maternal education (RR 1.6, 95% CI: 1.0-2.4) was associated with uncontrolled asthma. Parental necessity beliefs about medication use to maintain present and future health and parental concerns about potential adverse consequences of medication were also associated with uncontrolled asthma (RR 1.6, 95% CI: 1.1-2.2; and 1.6, 95% CI: 1.0-2.5, respectively).
  
  
  CONCLUSIONS
  Environmental factors and therapy adherence were not associated with asthma control. In our cohort, uncontrolled asthma is associated with low maternal education and with strong parental beliefs about medication necessity and higher concern about potential side effects of medication.
authors.affiliation: Division of Pharmacoepidemiology & Pharmacotherapy, Utrecht Institute for Pharmaceutical Sciences (UIPS), Faculty of Science, Utrecht University, Utrecht, The Netherlands.
authors.forename: Ellen S
authors.initials: ES
authors.lastname: Koster
authors.forename: Alet H
authors.initials: AH
authors.lastname: Wijga
authors.forename: Gerard H
authors.initials: GH
authors.lastname: Koppelman
authors.forename: Dirkje S
authors.initials: DS
authors.lastname: Postma
authors.forename: Bert
authors.initials: B
authors.lastname: Brunekreef
authors.forename: Johan C
authors.initials: JC
authors.lastname: De Jongste
authors.forename: Henriette A
authors.initials: HA
authors.lastname: Smit
authors.forename: Maarten O
authors.initials: MO
authors.lastname: Hoekstra
authors.forename: Jan A M
authors.initials: JA
authors.lastname: Raaijmakers
authors.forename: Anke-Hilse
authors.initials: AH
authors.lastname: Maitland-van der Zee
mesh_terms: D000280:Administration, Inhalation; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000627:therapeutic use*; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy*; D002648:Child; D015331:Cohort Studies; D004522:Educational Status; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D055118:Medication Adherence; D010290:Parents / Q000523:psychology*; D011795:Surveys and Questionnaires
chemical_list: D000305:Adrenal Cortex Hormones; D018927:Anti-Asthmatic Agents