What Is Needed to Improve Pediatric Asthma Controller Therapy Adherence


From better education, to remote monitoring and consistent check-ins, clinicians may need to initiate better adherence in their younger, severely ill patients.

William Anderson, MD

William Anderson, MD

At the American Academy of Allergy, Asthma & Immunology (AAAAI) 2021 Virtual Sessions this weekend, a late-breaking poster showed just more than half (57%) of pediatric patients with severe asthma adhered to their controller medication when monitored with a dose-administered feedback device.

The findings, from a team at the Children’s Hospital Colorado, indicates even a high-risk population—who agreed to voluntary treatment monitoring, even—reports asthma controller adherence at a rate close to greater patient population averages.

In the second segment of an interview with HCPLive®, study author William Anderson, MD, discussed the concepts of remotely-monitored treatment adherence for asthma, the value of in-person versus telehealth check-ins during the COVID-19 pandemic, and overall thoughts on the virtual AAAAI 2021 sessions.

When doing assessments that involve patients knowingly playing a part of monitored treatment adherence, you would hope for better outcomes from them, in terms of them actually following prescriptions.

But, as you as you alluded to, that's indicative of its own outcome, and the need for better patient confidence in therapy. Would that mean improved education for patients?

Anderson: I think it's both education and communication. I think that, for a lot of providers, they don't know exactly what's happening in the home when it comes to taking these medications. And knowing what the rate of the patient's medication adherence is allows them to have that conversation with families to point out, 'Hey, this is the adherence that we're seeing for you. One, do you recognize that that's the only how frequent you're taking your medication? And if so, why is it that you're only taking your medication that often?'

That's where you can really start to analyze some of the barriers that might be present to good medication adherence. Once you've identified those, there's tailoring your treatment options or strategies to what you're learning from the patient.

This broader discussion about remote monitoring and better means of assuring patients are working with confidence of what a prescribing clinician would hope for their treatment. And all that speaks to our current state of isolation and very prioritized in-person care.

But do these findings say anything to value of in-person care—to the idea that it’s something that does help with treatment adherence?

Anderson: I can't necessarily say at this point in time whether having less in-person care made a difference one way or the other, because we didn't necessarily look at that in this study. But I will say that it just goes to show the importance of making sure you do continue the continuity of care with these patients. I think that those patients who are not getting routine feedback or are not having these conversations with providers—maybe they are who's more likely start to slip a little bit on taking their medications.

So, if you're able to have those conversations in person, via telehealth, whatever it might be, I think it's just important to make sure that to continue this one way or the other. We don't want to see our patients in a time like COVID be afraid to come into the office, and then we lose them to follow-up, and then their asthma actually gets worse during that time.

So, if you can reach out in terms of an electronic intervention, telehealth, whatever it might be, we certainly want to maintain those on that connection with patients and that care, even during a pandemic.

Is there anything else you would want to add, relative to AAAAI 2021?

Anderson: I'm really excited. I'm looking forward to the virtual format. Obviously, it's great that we're able to have the meeting this year. Unfortunately, last year was canceled because of COVID. So, it's hard to believe that it's been a year at this point in time. But it should be a good meeting. Virtual is going to be fantastic, but we're looking forward to the day where we can meet up with our colleagues in-person again, hopefully very soon.

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