ArticlePatient preference and adherence2016
Non-adherence to inhaled corticosteroids and the risk of asthma exacerbations in children.
Article in Patient preference and adherence, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 2 of them syntheses that pooled it.
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Who cites it
10 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Omalizumab for pediatric allergic asthma: evidence-based insights on efficacy and safety from a meta-analysis of randomized trials.Frontiers in pharmacology · 2026Pooled it
- Pooled it
- Medication adherence trajectories and association with risk factors and clinical outcomes in type 2 diabetes treatment.PloS one · 2026Article
- Suitability of Measures of Pharmacy-Based Medication Adherence for Routine Clinical Use Among Patients with Chronic Diseases: A Systematic Review.Patient preference and adherence · 2025Review
- Prediction of Asthma Exacerbations in Children.Journal of personalized medicine · 2023Review
- Asthma medication adherence and exacerbations and lung function in children managed in Leicester primary care.NPJ primary care respiratory medicine · 2023Review
- Article
- Understanding relationships between asthma medication use and outcomes in a SABINA primary care database study.NPJ primary care respiratory medicine · 2022Article
- Observational
- The efficacy of a novel monitoring device on asthma control in children with asthma.Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology · 2020Article
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundNon-adherence to inhaled corticosteroids (ICSs) is a major risk factor for poor asthma control in children. However, little is known about the effect of adherence to ICS on the incidence of asthma exacerbations. The objective of this study was to examine the effect of poor adherence to ICS on the risk of exacerbations in children with asthma.
methodsIn this nested case-control study using data from the Dutch PHARMO Record Linkage System, children aged 5-12 years who had an asthma exacerbation needing oral corticosteroids or hospital admission were matched to patients without exacerbations. Refill adherence was calculated as medication possession ratio from ICS-dispensing records. Data were analyzed using a multivariable multiplicative intensity regression model.
resultsA total of 646 children were included, of whom 36 had one or more asthma exacerbations. The medication possession ratio was 67.9% (standard deviation [SD] 30.2%) in children with an exacerbation versus 54.2% (SD 35.6%) in the control group. In children using long-acting beta-agonist, good adherence to ICS was associated with a higher risk of asthma exacerbations: relative risk 4.34 (95% confidence interval: 1.20-15.64).
conclusionIn children with persistent asthma needing long-acting beta-agonist, good adherence to ICS was associated with an increased risk of asthma exacerbations. Possible explanations include better motivation for adherence to ICS in children with more severe asthma, and reduced susceptibility to the consequences of non-adherence to ICS due to overprescription of ICS to children who are in clinical remission. Further study into the background of the complex interaction between asthma and medication adherence is needed.
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