Risk factors hindering asthma symptom control in Saudi children and adolescents

Halwani, Rabih; Vazquez-Tello, Alejandro; Horanieh, Nour; Dulgom, Said; Aseri, Zohair Al; Alkhamis, Nouf; AlSum, Z; Al‐Jahdali, Hamdan; Al‐Muhsen, Saleh

doi:10.1111/ped.13268

Cited by 18 publications

(9 citation statements)

References 28 publications

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“…Two studies conducted in the Middle East found that about half of their participants reported a fear of inhaled corticosteroid’s side effects [ 25 ]. A similar finding was observed in a study conducted in Saudi Arabia [ 26 ], in which the majority of parents (60.3%) were concerned about the side effects of inhaled corticosteroids and about one-third of the parents were concerned about the potential dependency on asthma inhalers. On the contrary, in our study, only 7% of the parents were afraid that the inhalers would be harmful to their children, and only 1% of the parents were concerned about their children becoming dependent on inhaled corticosteroids.…”

Section: Discussionsupporting

confidence: 87%

Adherence to Asthma Controller Therapy Among Children in Majmaah City, Saudi Arabia

Alolayan

Alhammad

Almutairi

et al. 2021

Cureus

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Background and objectiveImproving adherence to asthma medications may prevent asthma exacerbation, which is associated with a decline in lung function. The purpose of this study was to assess the adherence to asthma controller therapy and the factors that might influence the level of adherence among asthmatic children. Materials and methodsWe conducted a prospective observational study at the King Khalid Hospital in Majmaah, Saudi Arabia between January and April 2020; the study was conducted among children aged 1-14 years with a diagnosis of asthma. The data collected when available included age and gender by using a pre-tested questionnaire that contained four validated items, and the respondents were the parents of the affected children. Due to the coronavirus disease 2019 (COVID-19) pandemic, the data collection was performed via phone calls to ensure safety. Informed consent was obtained from the parents. ResultsWe analyzed 152 asthmatic children to evaluate their adherence to asthma controller therapy. The majority of the children were males (60%). Asthma was most prevalent in the age group of 6-10 years (40.1%), followed by the age group of two to five years (32.9%). We found that the majority of the patients had poor adherence to asthma medication (83.6%) while the remaining had good adherence (16.4%). The total mean score for adherence to medication therapy was 5.16 (SD: 2.3). ConclusionsThe present study showed that the overall adherence level to the asthma controller therapy was poor among children. Larger, nationwide studies are needed to assess the adherence to asthma medications and implement interventions that can improve the same.

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Section: Discussionsupporting

confidence: 87%

Adherence to Asthma Controller Therapy Among Children in Majmaah City, Saudi Arabia

Alolayan

Alhammad

Almutairi

et al. 2021

Cureus

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“…Assessment of adherence, proper device use, control of environment, and confirmation of the diagnosis, especially if there is a failure to respond to therapy, are recommended each time before treatment adjustments. [355] For a child seen in the clinic for the first time while on controller treatment, the managing physician should ensure that the child is receiving the appropriate treatment based on recommendations given in the section on treatment initiation.…”

Section: Management Of Asthma In Childrenmentioning

confidence: 99%

The Saudi Initiative for Asthma - 2019 Update: Guidelines for the diagnosis and management of asthma in adults and children

et al. 2019

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This is the fourth version of the updated guidelines for the diagnosis and management of asthma, developed by the Saudi Initiative for Asthma (SINA) group, a subsidiary of the Saudi Thoracic Society. The main objective of the SINA is to have guidelines that are up to date, simple to understand, and easy to use by healthcare workers dealing with asthma patients. To facilitate achieving the goals of asthma management, the SINA panel approach is mainly based on the assessment of symptom control and risk for both adults and children. The approach to asthma management is now more aligned for different age groups. The guidelines have focused more on personalized approaches reflecting better understanding of disease heterogeneity with integration of recommendations related to biologic agents, evidence-based updates on treatment, and role of immunotherapy in management. The medication appendix has also been updated with the addition of recent evidence, new indications for existing medication, and new medications. The guidelines are constructed based on the available evidence, local literature, and current situation at national and regional levels. There is also an emphasis on patient–doctor partnership in the management that also includes a self-management plan.

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“…Not receiving proper asthma education or education about inhaler technique leads to uncontrolled disease 20. Inadequate asthma control is consequently translated into impairments in the patients’ health-related quality of life 21…”

Section: Introductionmentioning

confidence: 99%

<p>Role of the pharmacist in improving inhaler technique and asthma management in rural areas in Jordan</p>

Basheti¹,

Salhi²,

Basheti³

et al. 2019

CPAA

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Introduction Pharmacists can have a valuable role in educating patients on correct inhaler technique leading to improved asthma management. Rural areas can benefit from the role of the pharmacist considering the barriers found in attending primary health-care facilities. Objectives This study aimed to assess the impact of inhaler technique education delivered by pharmacists on patients’ inhaler technique, Asthma Control Test (ACT) score, forced expiratory volume in the first 1 second (FEV 1 %), and reliever use (puffs/day). Methods A pre–post interventional study was conducted over 6 months from February 2017 to July 2017 in rural areas in Jordan. Asthma patients visiting respiratory clinics and using metered dose inhaler (MDI) or turbuhaler (TH) controlled medication were randomly recruited. Inhaler technique was assessed via published checklists. The ACT, FEV 1 %, and reliever use (puffs/day) were assessed. Patients were educated on inhaler technique via demonstration with return demonstration education. All assessments were repeated 3 months post education. Results A total of 103 (TH, n=44; MDI, n=59) patients were recruited (mean age=46.5±13.5), 74% females. Patients reported an overuse of their reliever (5.1±4.2 puffs/day). Only 2 patients (1.9%) had well-controlled asthma, while the rest had either moderately (19.4%) or poorly (78.6%) controlled asthma. Patients using the MDI achieved 3.03±4.30 ACT score improvement ( p <0.001), which is a clinically significant improvement in control. Patients using the TH achieved a statistically significant improvement of 2.07±4.72 ( p =0.031). FEV 1 % improved significantly for MDI users ( p =0.005) but not for TH users ( p =0.097). Reliever use decreased significantly for MDI and TH users. Conclusion Asthmatic patients living in rural areas in Jordan reported poor inhaler technique, ACT scores, and FEV 1 % scores and high use of reliever medications. Pharmacist-led educational intervention resulted in improved inhaler technique scores, ACT scores, and FEV 1 % scores and lowered reliever use over time.

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Risk factors hindering asthma symptom control in Saudi children and adolescents

Cited by 18 publications

References 28 publications

Adherence to Asthma Controller Therapy Among Children in Majmaah City, Saudi Arabia

Adherence to Asthma Controller Therapy Among Children in Majmaah City, Saudi Arabia

The Saudi Initiative for Asthma - 2019 Update: Guidelines for the diagnosis and management of asthma in adults and children

<p>Role of the pharmacist in improving inhaler technique and asthma management in rural areas in Jordan</p>

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