Pearce, CJ; (2015) Adherence in Children with Problematic Severe Asthma. Presented at: The 2nd Annual Scientific Meeting 2015, Manchester, United Kingdom.

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Abstract

Background: Problematic severe asthma (PSA) is defined as poorly controlled asthma despite high levels of prescribed medications. The prevalence in childhood is between 5-10% of asthmatic children; however the amount of resources these patients consume is disproportionately high. PSA can be split into Difficult Asthma (DA) and Severe Therapy Resistant Asthma (STRA). DA is amenable to improvement by addressing relevant adherence, allergy and psychosocial issues. At least 50% of paediatric patients with PSA are classified as DA; with non-adherence being an issue for around half of these patients. Aims: 1. To identify the modifiable causes of non-adherence in children with PSA to inform an adherence intervention. 2. To use the Medical Research Council (MRC) guidance to develop an intervention for children with DA by tailoring support to overcome the perceptual and practical barriers to adhering to treatments, as recommended in the NICE Guidelines. Methods: Study 1: Literature reviews which summarises: 1. The known reasons for non-adherence in children with PSA 2. Effective components of previous asthma adherence interventions Study 2: A secondary analysis will be conducted, using electronic monitoring (SmartInhaler) collected in over 100 children with asthma, to investigate patterns of non-adherence to inform the intervention. Study 3: A mixed-methods cross-sectional study using validated questionnaires and qualitative interviews to identify potentially modifiable factors associated with non-adherence. Study4: The creation of an Intervention Development Group (IDG) consisting of researchers, clinicians and patients. The IDG will use the PhD results to develop an intervention manual. Study 5: Finally, a feasibility and acceptability pilot study of the intervention. Potential Implications: This PhD addresses the crucial question of non-adherence in children with PSA. It is intended that the intervention developed will lead to a multi-site Randomised Control Trial and roll- out within the NHS.

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