Compliance with using inhalers following an acute episode among asthmatic paediatric population in paediatric clinic at Teaching Hospital Batticaloa

Abstract

Bronchial Asthma (BA) is a highly prevalent chronic condition among pediatric populations, often requiring inhaler-based therapies to manage symptoms effectively. The aim of the study was to study the compliance of inhalers and its outcome following an acute attack in paediatrc population. To achieve that we studied about the adherence to inhalers , techniques and outcome following an acute attack in asthmatic paediatric population at paediatric clinic Teaching Hospital Batticaloa (THB). We have done a descriptive cross-sectional study done in paediatric clinics in THB from May to July 2023 using an interviewer administered questionnaire. Our sample is diagnosed patients with BA under 16 years old, who is on inhaler and had acute exacerbation of BA within last 1 year period. The setting of the study is paediatric clinic of THB. Sample size was selected by complete enumeration method to achieve maximum number of sample. The study was carried out among 118 children. Data collection was done after obtaining the consent from parents or guardians. We got ethical clearance from Ethical Review Committee of Faculty of Health Care Sciences, Eastern University Sri Lanka. Data analysis was done according to our objectives using the latest version of SPSS software. A total of 118 participants were included in our study N=60 (50.8%) among them were male children and N=58 (49.2%) were female children. The participants were between 1- 14 years old and the most N=12 (10.2%) of the patients were in the 4 and 9 years old categories. N=59 (50%) patients presenting to the paediatric clinic THB are adhering to inhaler following acute exacerbation of BA. Among the study population N=67 (57.6%) having poor inhaler technique. Main reason for poor adherence was forgetfulness N=25 (20.5%). As the outcome of poor adherence and poor inhaler technique, most of the patients N=80 (67.3%) got absent from school, but most of the patient’s N=60 (50.8%) concentration on studies didn’t get affected. Most of the patient’s N=67(56.8%) extra-curricular activities got affected. Most of the patients N=75 (63.6%) didn’t need rehospitalization following discharge after an acute exacerbation of BA. Majority of the parents’ N=75(63.6%) work days got affected due to continuous symptoms. But most of the parents’ N=84 (71.2%) didn’t have any income losses due to continuous symptoms. Most of the patients N=95 (80.5%) didn’t need ICU admission following 2 weeks of admission. Most of the population having poor adherence and poor technique according to our study. Main reason for poor adherence is forgetting to take medicine.This leads to poor attendance of children to school and absence from work for parents. This poor adherence and the poor techniques can be corrected by counselling and teaching about the technique. Prevention strategies and policies can be developed for preventing the acute attacks and re-hospitalization or ICU admission.