Only 36% of children with persistent asthma reported being prescribed any daily controller medication, and most did not have an asthma action plan or a peak flow meter.
For example, Levy et al [ 29] found that only 36% of asthmatic children in three public housing developments in Boston had been prescribed any daily controller medication.
Of note, of the 47 children categorized as having persistent asthma who provided information on their medications, only 36% reported being prescribed any daily controller medication (63% of severe persistent, 33% of moderate persistent, and 17% of mild persistent children).
Study exclusion criteria included; smoking in past 6 months, greater than 10 pack-years of lifetime smoking, upper respiratory infection in the previous 4 weeks, stable asthma (i.e. no exacerbation) in previous 4 weeks and any daily controller medications (i.e. steroids).
International and British asthma management guidelines recommend a stepwise approach to instituting and adjusting daily controller (preventer) anti-inflammatory therapy, beginning with the dose of inhaled corticosteroid (ICS) appropriate to the severity of asthma [ 6- 9].
Instead, agreement and partnership between parents, was a facilitator beneficial for the child's intake of daily controller treatment.
We identified a close relationship between reported barriers and facilitators to adherence to long-term daily controller medication for asthma within three loci of responsibility.
31 Prior morbidity (admissions, ED visits and rescue oral corticosteroids), asthma control using the Asthma Quiz for Kidz, 128 reported use of daily controller medications, environmental factors (eg, dust, animals and pollen) and perceived trigger of the exacerbation will be documented.
The most recent Canadian guidelines recommend that the use of daily controller therapy be promptly reassessed in any patient requiring an oral corticosteroid and that these patients be referred to a specialist in the case of frequent courses of oral corticosteroids [ 3].
We also aimed to develop a taxonomy of barriers and facilitators to support the development of knowledge translation interventions to increase patients' adherence to daily controller medication for asthma over the long-term [ 23].
