Asthma Research into Action
Getting Children to Take Their Inhaled Corticosteroids: Different Year, Same Challenge
It has been nearly 11 years since the National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health (NIH) funded an important 5-year, 1,000-child Childhood Asthma Management Program (CAMP) study. The longest and largest study of the effectiveness and safety of inhaled corticosteroids (ICS) for children, CAMP revealed that ICS provided superior asthma control for 5- to 12-year-olds with only a temporary side effect—a small reduction in growth rate during the first year of treatment.
Despite these findings, the passage of time, and recognition by clinicians that ICS are safe and effective for the long-term treatment of children with mild to moderate persistent asthma, the use of ICS is still inconsistent.
Fernando Martinez, M.D.—pediatric pulmonologist, director of the Arizona Respiratory Center, and member of the NHLBI’s National Asthma Education and Prevention Program responsible for establishing clinical guidelinesfor the diagnosis and management of asthma—explains why.
“There is still some fear of steroids by patients and their parents, but the real challenge is to get them to take their medication consistently. For ICS to work, they must be taken daily.” said Dr. Martinez. “Getting any patient to take any medication every day is a challenge: Once they start feeling better, they stop taking the medication, even though it’s the medication that’s helping them feel better. With children and adolescents there is an added problem: They feel invincible.”
Make no mistake about it, invincibility is only a feeling. Anyone familiar with asthma knows that it is a lifelong disease that requires appropriate, long-term therapy.
ICS won’t cure asthma. But, patients who take their ICS every day—as well as follow their asthma action plan, control environmental triggers, and see their health care provider regularly to make sure their asthma stays in control—will be able to breathe easier and reduce their chances of symptoms or an asthma attack that could land them in the hospital.
Dr. Martinez and several fellow researchers have been actively investigating how to keep even more patients out of the hospital, and out of harm’s way, by exploring creative strategies to address the ICS challenge.
“We need to recognize that some 60 percent of patients won’t take their medication daily, to adapt to that reality, and to be very open as clinicians and researchers to changing traditional approaches and thinking out-of-the box in terms of solutions,” said Dr. Martinez.
Dr. Martinez and his colleagues recently published a study in the The Lancet, looking at new ways to improve patient adherence. Learn more.
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Last Updated April 2011