A descriptive study on usage of inhaled steroids in children

Objective To determine the use of inhaled corticosteroids in a cohort of children at Lady Ridgeway Hospital (LRH), Colombo.

Method A cross-sectional descriptive study was carried out on all clinic and in-ward patients of ward 4 LRH receiving inhaled corticosteroids for more than 6 months. A pre-tested, structured interviewer administered questionnaire was used to collect data on the demography, type of drug and device, adherence and response to therapy.

Results The study population comprised 185 children, 55% of whom were males and 35% in the 2-5 year age group. In 90% the inhaled steroid was beclomethasone. Metered dose inhaler was used by 64% and dry powder inhaler by 36% for steroid delivery. Ninety six percent of the study population used the correct inhaler device for their age group. The commonest indication for inhaled steroid was moderate persistent bronchial asthma. The technique was demonstrated at initiation to 99.5% of the users by the prescriber. Eighty four percent of the study population practised a ‘good’ technique. Nearly 80% of the patients adhered to the therapy daily and attended the clinic regularly. Around 15% needed hospitalisation. About 96% showed restricted lifestyles, mainly consumption of iced food. Inhaler technique of the patient had a significant effect on the clinical response to therapy (p<0.05).

Conclusions Beclomethasone was the most commonly used inhaled corticosteroid in the study. Ninety six percent used the correct inhaler device for their age group. Inhaler technique had a significant effect on the clinical response. About 96% had restricted lifestyle despite optimal control.

Sri Lanka Journal of Child Health, 2010; 39: 128-132

(Key words: Corticosteroids, beclomethasone, inhaler device, bronchial asthma)

doi: 10.4038/sljch.v39i4.2477