Suboptimal persistence with inhaled corticosteroid monotherapy among children with persistent asthma in the UK

BACKGROUND: Long-term studies indicate that adherence to asthma controller therapy decreases over time, and persistence with therapy may be poor. METHODS: This primary care database study assessed persistence with therapy over one year after first prescription of inhaled corticosteroid (ICS) for children aged 2-14 years with a diagnosis of asthma. Children with intermittent asthma were excluded. Discontinuation was defined as no ICS prescription during the last three months of the follow-up year. RESULTS: 2220 of 7375 children receiving a first prescription for ICS had persistent asthma. Mean (±SD) age was 7.3 (±3.8) years; 59.5% were male. A total of 745 (33.6%) continued initial ICS, 133 (6.0%) received add-on therapy, 150 (6.8%) switched to another asthma therapy, and 1192 (53.7%) discontinued therapy. These percentages were similar for children aged 2-5 or 6-14 years. CONCLUSION: Persistence with first-time ICS monotherapy is poor among children with persistent asthma.