title: Guideline-recommended use of asthma medication by children is associated with parental information and knowledge: the PIAMA birth cohort.
abstract: OBJECTIVE
  We investigated the use of asthma medication by children and the association of use as recommended by guidelines with modifiable risk factors: parental attitudes, knowledge of asthma medication and information provided by health care providers.
  
  
  METHODS
  Questionnaire data were obtained from parents of 229 8-year-old children participating in the prevention and incidence of asthma and mite allergy birth cohort who used asthma medication in the past 12 months. They reported on their child's medication use, their own knowledge and attitudes towards the medication and their satisfaction with the information they received from health care providers.
  
  
  RESULTS
  Irregular use of inhaled corticosteroids (ICS) was common: 40% of the parents only gave their child ICS when the child felt breathless and 52% only 'when the child needed it'; 15% of the parents tried to avoid giving medication, and about 25% of the parents sometimes discontinued medication. Parental knowledge of how asthma medication should be given was a major determinant of guideline-recommended use: Of the parents who knew that anti-inflammatory drugs should be taken everyday (53% of all parents), 84% reported that they actually gave their child the medicines everyday as compared with 25% of the parents who did not know this. Guideline-recommended use was also significantly associated with parental satisfaction with the amount of information received from health care providers. These associations were independent of maternal school education.
  
  
  CONCLUSIONS
  Our findings suggest that substantial improvements in the use of asthma medication are feasible, and this could considerably improve the effectiveness of current asthma treatment.
authors: Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands.
authors: Alet H
authors: AH
authors: Wijga
authors: Mira G P
authors: MG
authors: Zuidgeest
authors: Marjan
authors: M
authors: Kerkhof
authors: Gerard H
authors: GH
authors: Koppelman
authors: Henriëtte A
authors: HA
authors: Smit
authors: Johan C
authors: JC
authors: de Jongste
mesh_terms: D000280:Administration, Inhalation; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy*; D001294:Attitude to Health; D002648:Child; D005938:Glucocorticoids / Q000008:administration & dosage / Q000627:therapeutic use; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D055118:Medication Adherence; D010290:Parents / Q000523:psychology*; D017410:Practice Guidelines as Topic; D012307:Risk Factors; D011795:Surveys and Questionnaires
chemical_list: D018927:Anti-Asthmatic Agents; D005938:Glucocorticoids
keywords: adherence; asthma medication; children; guidelines; parental knowledge; pharmacoepidemiology