Complex analysis of factors of compliance with bronchial asthma therapy in children and assessment of methodological approaches to improve its effectiveness

This study assessed treatment adherence in children with asthma, revealing that up to 90 % of patients exhibit low adherence associated with poor disease control. A single, individualized training session was shown to significantly reduce inhalation technique errors, especially when using metered-dose inhalers and nebulizers. The authors emphasize the need for comprehensive measures, including regular training and digital monitoring, to improve this situation. The aim of the study was to comprehensively assess treatment adherence in children with asthma, identify clinical, demographic, and organizational factors influencing it, and evaluate the effectiveness of educational interventions to correct inhalation technique errors. Materials and methods: A cross-sectional study included 30 children with bronchial asthma. Clinical and anamnestic data were collected, disease control was assessed using Asthma Control Test and the Morisky – Green adherence scale. Inhalation technique was analyzed using metered-dose inhalers, metered-dose powder inhalers, and nebulizers, followed by individual training and reassessment. Results: Most patients had low adherence (up to 90 % according to the Morisky – Green scale), and this indicator was practically independent of age and asthma severity, but was associated with an increased frequency of uncontrolled disease according to the results of asthma control tests, especially in moderate and severe asthma. Before training, the highest frequency of critical errors was observed with metered-dose powder inhalers and aerosol inhalers, whereas after a single individual training session, the proportion of patients without inhalation technique errors significantly increased, especially among users of metered-dose inhalers and nebulizers. Conclusion: Low adherence to asthma therapy in children is almost universal and requires comprehensive interventions, including regular inhalation skill assessment, individualized age-appropriate training, and the use of digital monitoring technologies.

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