PURPOSE: The global Room to Breathe survey was conducted to establish current parental attitudes regarding their child’s asthma, as both parental viewpoints and medical care determine children’s asthma control. Here we report parental concerns regarding use of inhaled corticosteroid (ICS) medication and the subsequent impact on childhood asthma control in Canada.
METHODS: Interviews were conducted with families with ≥1 child (aged 4-15 years) with physician-diagnosed asthma, in parents and children (≥8 years) by telephone (Canada, Greece, Hungary, The Netherlands and United Kingdom) or face-to-face (South Africa).
RESULTS: 1284 parental interviews were conducted (228 in Canada). All comparisons presented here are parental reports in Canada vs other countries surveyed. Use of ICS was reported significantly more by Canadian children (75.4% vs 63.7%, P< 0.001) suggesting increased guideline adherence. For parents of children using ICS, over half reported that they were ‘very concerned’ or ’quite concerned’ about using steroid medication (56.1% vs 59.3%, P=0.455). Canadian parents were more likely to report side effects from ICS use (24.0% vs 17.4%, P=0.049). However, they were less likely to be ’very concerned’ about the use of steroids than parents (odds ratio [OR] 0.51; 95% confidence interval [CI] 0.32-0.79, P=0.0019). 11.8% of Canadian children achieved complete GINA guideline-defined control; this was not significantly worse than other countries (11.8% vs 15.3%, P=0.175). From a possible five items of asthma control, 30.3% (n=69) of Canadian children had one uncontrolled item, 29.0% (n=66) had two uncontrolled items and a further 29.0% (n=66) had ≥ three uncontrolled items. Children from Canada whose parents expressed concern about the use of ICS were three times more likely to have >2/5 uncontrolled GINA scores (OR 3.124; 95% CI 1.44-7.01, P=0.0016).
CONCLUSION: Concerns about the use of steroid medication persist globally and in Canada; this is associated with poor asthma control.
CLINICAL IMPLICATIONS: Parental concerns about the use of ICS may reduce adherence and predict incompletely controlled asthma in Canadian children.
DISCLOSURE: William Carroll, Grant monies (from industry related sources) William D. Carroll has received fees for performing research from GlaxoSmithKline, Merck Sharp & Dohme, Novartis, Teva and Nycomed. Johannes Wildhaber and Paul L.P. Brand have received fees for performing research from GlaxoSmithKline, AstraZeneca, Merck and Nycomed.; Consultant fee, speaker bureau, advisory committee, etc. William D. Carroll has received fees for giving presentations and consultancy from GlaxoSmithKline, Merck Sharp & Dohme, Novartis, Teva and Nycomed. Johannes Wildhaber and Paul L.P. Brand have received fees for giving presentations and consultancy from GlaxoSmithKline, AstraZeneca, Merck and Nycomed.; Other William D. Carroll has received sponsorship and support to attend respiratory meetings from GlaxoSmithKline, ALK-Abelló, Merck Sharp & Dohme and Nycomed.; No Product/Research Disclosure Information