Measurement of children's asthma medication adherence by self report, mother report, canister weight, and Doser CT

Bruce Bender, Fredericks Wamboldt, Shannon L. O'Connor, Cynthia Rand, Stanley Szefler, Henry Milgrom, Marianne Z. Wamboldt

Research output: Contribution to journalArticlepeer-review


Background: Accurate assessment of medication adherence has been difficult to achieve but is essential to drug evaluation in clinical trials and improved outcomes in clinical care. compare four adherence assessment Objective: This study was conducted to methods: child report, mother report, canister weight, and electronic measurements of metered dose inhaler (MDI) actuation. Methods: Participants included 27 children with mild-to-moderate asthma who were followed prospectively for 6 months. All patients used an MDI equipped with an electronic Doser attached to their inhaled steroid. At each 2-month follow-up visit, Doser and canister weight data were recorded, while child and mother were interviewed separately regarding medication use. Results: Children and mothers reported, on average, over 80% adherence with the prescribed inhaled steroid. Canister weight revealed, on average, adherence of 69%, significantly lower than self-report. When adherence recorded by the electronic Doser was truncated to no more than 100% of prescribed daily use, average adherence was 50%. Older children and adolescents, nonwhite children, and those from poorer functioning families were least adherent. Conclusions: Electronic adherence monitoring was significantly more accurate than self-report or canister weight measures. Such accuracy is an essential prerequisite to increasing understanding of the treatment, setting, and patient factors that influence adherence, and to the consequent design of effective intervention strategies.

Original languageEnglish (US)
Pages (from-to)416-421
Number of pages6
JournalAnnals of Allergy, Asthma and Immunology
Issue number5
StatePublished - 2000
Externally publishedYes

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Pulmonary and Respiratory Medicine


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