Treatment adherence and level of control in moderate persistent asthma in children and adolescents treated with fluticasone and salmeterol Please cite this article as: Jentzsch NS, Silva GC, Mendes GM, Brand PL, Camargos P. Treatment adherence and level of control in moderate persistent asthma in children and adolescents treated with fluticasone and salmeterol. J Pediatr (Rio J). 2019;95:69–75. ,☆☆ ☆☆ The medications and spacers were provided free of charge through the Brazilian Unified Health System (SUS) of Belo Horizonte City Hall.

Nulma S. Jentzsch Gabriela C.G. Silva Guilherme M.S. Mendes Paul L.P. Brand Paulo Camargos About the authors

Abstract

Objective:

There is a scarcity of studies that assessed the association between adherence to combination therapy and asthma control in pediatric patients. The authors investigated the association between adherence to fluticasone propionate/salmeterol xinafoate combination-metered aerosol and the level of asthma control in children.

Methods:

This was a prospective observational study of 84 patients aged 5–16 years with moderate persistent asthma, who remained uncontrolled despite the use of 1000 µg/day of inhaled nonextrafine-hydrofluoric alkane-beclomethasone dipropionate in the three months prior to study enrollment. Participants were prescribed two daily doses of FP (125 µg)/salmeterol xinafoate (25 µg) combination by metered aerosol/spacer for six months. Adherence rates were assessed using the device's dose counter after the 2nd, 4th, and 6th months of follow up. Asthma control was assessed using a simplified Global Initiative for Asthma 2014 Report classification.

Results:

Mean adherence rates after the second, fourth, and sixth months were 87.8%, 74.9%, and 62.1% respectively, for controlled asthma, and 71.7%, 56.0%, and 47.6% respectively, for uncontrolled asthma (all p-values ≤ 0.03). The proportion of children achieving asthma control increased to 42.9%, 67.9% and 89.3% after the 2nd, 4th and 6th months of follow-up, respectively (p ≤ 0.001).

Conclusion:

Adherence rates between 87.8% in the 2nd month and 62.1% in the 6th month were strong determinants of asthma control.

KEYWORDS
Asthma; Fluticasone; Salmeterol; Inhaled corticosteroids

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