Parents' fears and concerns toward inhaled corticosteroid treatment for their asthmatic children

Asthma is the most prevalent chronic illness among children. Although inhaled corticosteroids are the recommended controller drug for treatment and prevention of childhood asthma attacks, long-term adherence is low. Our study aimed to determine the prevalence of fears and concerns of parents of children with asthma toward corticosteroid treatment, and the relationship of these concerns with level of adherence with therapy. Fifty mothers of asthmatic children aged 1-13 years, attending the Primary Care Pediatric Center in Beer-Sheva, were included in the study. Long-term inhaled corticosteroids were recommended to all the children. Four mothers refused to participate. Forty-six mothers were interviewed using a structured questionnaire regarding the presence of fears and concerns toward the use of inhaled corticosteroids. They were divided into two groups according to the presence or absence of fears and concerns toward the treatment. Data regarding asthma history, socioeconomic status, level of adherence to treatment, sources of information regarding asthma treatment, and the use of alternative medicine were also collected. Fourteen (30.4%) mothers reported fears and concerns related to chronic treatment of their children with inhaled corticosteroids (concerned mothers). Thirty-two mothers (69.6%) expressed no fears regarding this treatment (confident mothers). Both groups were similar in their socioeconomic status. Five of 14 (35.7%) concerned mothers compared with only one of 32 (3.1%) confident mothers reduced the recommended dosage (p = 0.004), More concerned mothers tend to receive information from lay literature, friends, and relatives and to use alternative homeopathic treatment compared with confident mothers. Among concerned mothers, the reasons mentioned for their concerns were risk of addiction (64%), weight gain or stunting (50%), toxicity (35%), and irritability or hyperactivity (57%). Maternal fears and concerns about the potential side effects of prolonged inhaled corticosteroid treatment on their asthmatic children are fairly common and tend to decrease their adherence to treatment.