Compliance with pharmacologic prophylaxis and therapy in bronchial asthma

F. Alessandro, Gian Vincenzo Zuccotti, S. Marco, G. Marcello, R. Enrica

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Between January 1 and December 31, 1988, 288 children [185 boys and 103 girls, mean age 8.75 ± 4.98 years (range 2.50 to 16.83)], followed at the Outpatient Clinic for Lung Diseases of the University of Milan 5th Pediatric Department, were interviewed blindly in order to assess their compliance with pharmacologic therapy. All children were suffering from episodic, frequent, or chronic asthma requiring therapy as needed and preventive drugs for at least 30 days. Prophylaxis (including cromolyn, beclomethasone, theophylline retard, ketotifen, oxatomide, albuterol, and prednisone, alone or in combinations) and therapy in case of symptoms (albuterol, with or without theophylline prompt or beclomethasone) were prescribed. A study questionnaire was completed 30 to 45 days after the prescription with no advance warning by a physician unaware of the prophylactic and therapeutic prescriptions. Out of the 288 patients, 31 (10.8%) failed to return for the second visit. Understanding of prophylaxis was full in 61.1% of cases, partial in 23.3% and nil in 4.9%. Therapy as needed was fully remembered by 77.1% of parents, partially by 9.4% and totally forgotten by 2.8%. Compliance with single-drug prophylaxis was full in 60.1% of cases, partial in 22.2% and nil in 6.4%. Statistical analysis showed compliance was significantly better for ketotifen than for disodium cromoglycate (chi squared 9.85, P <.02), for ketotifen than for theophylline (chi squared 9.98, P <.02), and for beclomethasone than for theophylline (chi squared 8.77, P <.05). In the group with single- drug prophylaxis, compliance was significantly better for dry inhalers than for aerosol (chi squared 9.91, P <.05), for oral route than for dry inhalers (chi squared 12.66, P <.01), and for metered-dose inhalers (MDI) than for dry inhalers (chi squared 13.99, P <.01). Compliance with the therapy prescribed for use as needed was complete in 63.0% of cases, partial in 13.0%, and nil in 23.9%. The degree of compliance with the various types of therapy prescribed did not appear to differ. Children reporting cough had a higher percentage of evasion than children reporting wheezing and/or dyspnea (chi squared 20.81, P <.005). Specific educational programs are necessary to improve the undertreatment of asthma and to lower the risk of irreversible lung damage.

Original languageEnglish
Pages (from-to)135-140
Number of pages6
JournalAnnals of Allergy
Issue number2
Publication statusPublished - 1994

ASJC Scopus subject areas

  • Immunology and Allergy


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