Adherence of pediatric asthma patients with oral corticosteroid prescriptions following pediatric emergency department visit or hospitalization.

OBJECTIVE: To determine caregiver adherence to oral corticosteroids prescribed in the emergency department for pediatric patients with an acute asthma exacerbation and to identify caregivers' perceived barriers to adherence with prescribed oral corticosteroids.
METHOD: We conducted telephone interviews 7 to 9 days following a patient's presentation to an urban children's hospital emergency department for an acute asthma exacerbation. The telephone interview conducted with caregivers of pediatric asthma patients included questions regarding whether caregivers filled a prescription for an oral corticosteroid, the number of days the caregiver gave the medication, and the perceived barriers to adherence by the caregiver.
RESULTS: During the study period, oral corticosteroid prescriptions were written for 161 of 172 patients completing the phone interview (93.6%). Of these patients, 98.7% reported filling the prescription, with caregivers of female patients and adolescent patients less likely to fill prescriptions than caregivers of male and younger patients. Asthma patient caregivers, however, reported adherence to the prescribed length of oral corticosteroid therapy only 64% of the time. Caregivers worried about the side effects of oral corticosteroids 60% of the time.
CONCLUSIONS: Efforts to increase corticosteroid adherence in children with acute asthma exacerbations should consider the causes for variation in caregiver adherence with length of therapy as well as caregiver perceptions regarding corticosteroid side effects.