Overview of delivery system issues in pediatric asthma.

The range of drugs now available to treat asthma should guarantee that almost all patients are treated effectively, and yet asthma still causes significant morbidity. The delivery system is a vital part of treatment, and its selection requires close attention to ensure optimal drug delivery to each individual patient. Children's physical capabilities change as they mature, and so the more convenient and portable systems, which may be impossible for initial consideration, become available for use as they grow. Treatment devices must be selected to ensure effective use, especially when the child is not well. Device technique should be reassessed at every clinic visit. Non-compliance is a major cause of apparent treatment failure. Most non-compliance is because the patient or caregiver feels uncertain about some aspects of the treatment process. The clinician must explain to the patient and caregiver the goals of therapy, the effects of the medications involved, and how the devices and drugs should be used to treat asthma. For educational material to be at its most effective, it must be individualized. Knowledge of how children and adults learn during different stages of their life will assist the education process. Selection of the delivery system and optimal device technique are essential in the management of asthma. The patient and caregiver are vital parts of this process and must know what to do.