Astım Tanısı Olan Çocuk Hastalarda Ebeveynlerinin Kortkiosteroid Tedavisi Hakkındaki Korku ve Endişelerinin Değerlendirilmesi

Yıl 2024, ERKEN GÖRÜNÜMLÜ MAKALELER, 1 - 7

Azize Pınar Metbulut

https://doi.org/10.12956/tchd.1502150

Öz

Amaç: Çalışmamızın amacı astımlı çocukların ebeveynlerinin inhale kortikosteroid kullanımına yönelik endişelerini ve korkularını ve astım yönetimi üzerindeki etkisini belirlemekti.

Gereç ve Yöntemler: Bu prospektif çalışmaya, 01.04.2023 ile 01.06.2024 tarihleri arasında Dr.Burhan Nalbantoğlu Hastanesi Çocuk İmmünoloji ve Alerji Kliniği’nde astım tanısıyla takip edilen hastalar alındı.

Bulgular: Çalışmamızda 100 hasta vardı. Hastaların 67’si (%67) erkekti. Çocukların ortanca yaşı 84.5 ay (IQR, 73.2-119.5)’di. Astım tanısının ortanca yaşı 65.5 ay (IQR, 24-76.75)’di. Hastaların tamamı astım tanısı ile tedavi almaktaydı ve 87 (%87) hasta tedavisini düzenli olarak kullanıyordu. Toplam 100 ebeveynden 78’i (%78) çocuklarında uzun süre kortikosteroid tedavisinin olası olumsuz etkileri konusunda korku ve endişe duyduğu saptandı. En yaygın korku ve endişeler, 34 (%34) ebeveynde kilo alımına, 33 (%33) ebeveynde ilaca bağımlılığa ve 27 (%27) ebeveynde büyüme geriliğine neden olması olarak tanımlandı. Kortikosteroid korkusu olan hastalar ilaç kullanımında zorluk yaşamaeğilimindeydi (p=0.001). Astım tedavisini bilmeyen ve kortikosteroidin astımdaki rolünü bilmeyen hastalar kortikosteroid tedavisinden korkma eğiliminde değildi (sırasıyla p=0.046 ve 0.001).

Sonuç: Çalışmamızda ebeveynlerin %78’i kortikosteroid tedavisinin olası olumsuz etkileri konusunda korku ve endişe duyduğu saptandı. En yaygın korku ve endişeler kilo alımı, ilaca bağımlılık ve büyüme geriliği ile ilgiliydi.

Anahtar Kelimeler

astım, çocuk, kortikofobi

Evaluation of Parents’ Opinions About the Fear of Inhaler Corticosteroid Treatment in Child Patients Diagnosed with Asthma

Öz

Objective: The aim of our study was to determine concerns and fears of parents of children with asthma towards the use of ICS, and its’ impact on asthma management.

Material and Methods: This prospective study was conducted between 01.04.2023 and 01.06.2024, at the Dr.Burhan Nalbantoğlu Hospital, The Pediatric Immunology and Allergy Clinic, and patients who had been followed up with asthma diagnosis, were included.

Results: There was 100 patients in our study. Out of 100 patients, 67 (67 %) were male. The median age of the children was 84.5 months (IQR,73.2-119.5). The median age of asthma diagnosis was 65.5 months (IQR, 24-76.75). All of the patients were using asthma maintenance therapy, and 87 (87%) patients were using it regularly. Out of 100 parents, 78 (78 %) had fear and concern of potential adverse effects of using inhaled corticosteroid treatment long time in their children. The most common fears and concerns were described as causing weight gain in 34 (34%) parents, dependance to drug in 33 (33%) parents, and causing growth retardation in 27 (27 %) parents. Patients having fear of corticosteroid tended to have difficulties in medicine use (p=0.001). Patients not knowing the treatment of asthma, and not knowing the role of corticosteroid in asthma tended not to have fear of corticosteroid treatment (p=0.046, and 0.001 respectively).

Conclusion: In our study, 78% of the parents had fear and concern of potential adverse effects of inhaled corticosteroid treatment. The most common fear and concerns were about weight gain, dependance to drug, and growth retardation.

Anahtar Kelimeler

asthma, child, corticophobia

Kaynakça

• 1. Akinbami LJ, Simon AE, Rossen LM. Changing Trends in Asthma Prevalence Among Children. Pediatrics 2016;137:1-7.
• 2. Asher MI, W eiland SK. The International Study of Asthma and Allergies in Childhood (ISAAC). ISAAC Steering Committee. Clin Exp Allergy 1998;28:52-66. 

• 3. https://ginasthma.org/gina-reports/
• 4. Boulet LP. Perception of the role and potential side effects of inhaled corticosteroids among asthmatic patients. Chest 1998;113:587-92.
• 5. Zedan M, Regal MEE, Osman EA, Fouda AE. Steroid Phobia among Parents of Asthmatic Children: Myths and Truth. Iran J Allergy Asthma Immunol 2010;9:163-8.
• 6. Vrijens B, Geest SD, Hughes DA, Przemyslaw K, Demonceau J, Ruppar T, et al. A new taxonomy for describing and defining adherence to medications. Br J Clin Pharmacol 2012 ;73:691-705.
• 7. Hui RWH. Inhaled corticosteroid-phobia and childhood asthma: Current understanding and management implications. Paediatr Respir Rev 2020:33:62-6.
• 8. Ip KI, Hon KL, Tsang KYC, Leung TNH. Steroid phobia, Chinese medicine and asthma control. Clin Respir J 2018;12:1559-64.
• 9. Özçeker D, Uçkun U, İslamova D, Tamay Z, Güler N. Corticosteroid phobia among parents of asthmatic children. Turk J Pediatr 2018;60:142-6.
• 10. Mathes T, Pieper D, Antonie SL, Eikermann M. 50% adherence of patients suffering chronic conditions- where is the evidence?. Ger Med Sci 2012;10:Doc 16. doi: 10.3205/000167.
• 11. Katz Y, Goldberg M. Non-adherence, non-compliance or non-concordance in asthma: Patients not following the medical regimen. IMAJ 2007;9:389-90.
• 12. Hossny E, Rosario N, Lee BW, Singh M, Ghoneimy DE, Soh JY, Souef PL. The use of inhaled corticosteroids in pediatric asthma: update. World Allergy Organ J 2016;9:26.
• 13. Duvnjak JP, Vukozac EL, Matana A, Mikic IM. Parents’ beliefs about medicines and their influence on inhaled corticosteroid adherence in children with asthma. Children (Basel) 2024;11:167.
• 14. Trojanowska A, Emeryk A, Zarzycka D. Adherence to therapy regimen by children with asthma and their parents. Postepsy Dermato Alergol 2022;39:258-64.
• 15. Pruteanu AL, Chauhan BF, Zhang L, Prietsch SO, Ducharme FM. Inhaled corticosteroids in children with persistent asthma: dose response effects on growth. Cochrane Database Syst Rev 2014;2014:CD009878.
• 16. Abu-Shaheen A, Alfayyad I, Nofal A, Al Tannir M, Al Madaney M, Heena M. Perceptions and practices in parents of Saudi Children with asthma: A cross-sectional survey. Cureus 2018;10:e2213.
• 17. Roncada C, Oliveira SG, Cidade SF, Rafael JG, Ojeda BS, Dos Santos BR, et al. Asthma treatment in children and adolescents in an urban area in southern Brazil: popular myths and features. J Bras Pneumol 2016;42:136-42. 18. Bush, A. Inhaled Corticosteroid and Children’s Growth. Arch Dis Child 2014;99: 191–92. 

• 19. Kwda A, Gldc P, Baui B, Kasr K, Us H, Wijeratne S, et al. Effect of long term inhaled corticosteroid therapy on adrenal suppression, growth and bone health in children with asthma. BMC Pediatr 2019;19:411.
• 20. Price D, Castro M, Bourdin A, Fucile S, Altman P. Short-course systemic corticosteroids in asthma:striking the balance between efficacy and safety. Eur Respir Rev 2020;29:190151.
• 21. Alyasin S, Sadeghi FS, Saki F, Dabaghmanesh M. Evaluation of vitamin D deficiency and low bone mass in children with asthma in fars province: A case control study. Health Sci Rep 2024;7:e2086.
• 22. Gray N, Howard A, Zhu J, Feldman L, To T. Association between inhaled corticosteroid use and bone fracture in children with asthma. JAMA Pediatr 2018 ;172:57-64.
• 23. Schlienger RG, Jick SS, Meier CR. Inhaled corticosteroids and risk fractures in children and adolescents. Pediatrics 2004;114:469-73.
• 24. Loke YK, Gilbert D, Thavarajah M, Blanco P, Wilson AW. Bone mineral density and fracture risk with long-term use of inhaled corticosteroids in patients with asthma: systematic review and meta-analysis. BMJ Open 2015;5:e008554.
• 25. Rangachari P, May KR, Stepleman LM, Tingen MS, Looney S, Liang Y, et al. Measurement of key constructs in a holistic framework for assessing self management effectiveness of pediatric asthma. Int J Environ Res Public Health 2019;16:3060.
• 26. Duvnjak JP, Vukozac EL, Ursic A, Matana A, Mikic IM. Perception of ıllness and fear of inhaled corticosteroid use among parents of children with asthma. Children (Basel) 2023;10:1597.