Nonadherence in Pediatric Asthma

Poor adherence, defined as less than 60% use of prescribed daily regimen, has been associated with poor control and high morbidity among people with asthma. It is estimated that 25% of children have uncontrolled asthma and nonadherence is believed to be one of the main causes. The prevalence of nonadherence differs between different age groups, with adolescents having the highest proportion of poor adherence. The following chapter reviews and analyzes the causes of intentional and nonintentional nonadherence and the challenges to adherence in different pediatric age groups. It also discusses the advantages and limitations of various subjective and objective adherence monitoring tools used in clinical practice and research. Finally, it reviews various educational interventions as well as the advantages and limitations of newer digital and web-based technology that has shown promising results but are expensive and still in need of validation. Better asthma outcomes and sustained adherence are best achieved by combining psychosocial interventions with education and monitoring.