Associations of inhaler technique, medication adherence, and parental illness perception on asthma control in childhood: a cross-sectional observational study.

OBJECTIVE

Effective pediatric asthma management relies on medication adherence, correct inhaler technique, and positive parental illness perception. This study examined the levels, interrelationships, and predictive value of these factors for asthma control among children aged 7-11 years.

METHODS

In this cross-sectional observational study, 62 children with asthma and their caregivers were recruited from community and clinical settings in Alabama, USA. Asthma control was assessed using the Childhood Asthma Control Test (C-ACT), medication adherence via the Medication Adherence Report Scale for Asthma (MARS-A), and parental illness perception via the Asthma Illness Representation Scale (AIRS), including five subscales: Attitudes Toward Medication Use, Treatment Expectations, Facts About Asthma, and Nature of Symptoms/Emotional Aspects. Inhaler technique was evaluated using a pressurized metered-dose inhaler (pMDI) with a spacer via a 9-step checklist. Descriptive statistics summarized outcomes, and correlations and regressions explored relationships.

RESULTS

Only 34.77% of participants demonstrated correct inhaler technique. Inhaler technique correlated positively with asthma control (rs = .25, p = .048), and medication adherence correlated with parental attitudes toward medication (rs = .46, p < .001). Regression showed that later age at diagnosis predicted poorer asthma control (B = -0.64, p = .008). Ordinal regression indicated that higher caregiver education (high school: B = -5.73, p = .019; college: B = -4.90, p = .027) and perceiving income as exceeding expenses (B = -4.63, p = .045) were associated with better asthma control.

CONCLUSIONS

Despite favorable control scores, incorrect inhaler use and suboptimal adherence remain challenges. Parental perceptions and sociodemographic factors, particularly education and financial well-being, significantly influence outcomes. Findings underscore the need for family-centered educational strategies to improve pediatric asthma management.