Medication use in uncontrolled pediatric asthma: Results from the SysPharmPediA study

on behalf of the SysPharmPediA consortium, Amir Hossein Alizadeh Bahmani, Elise M.A. Slob, Lizan D. Bloemsma, Susanne Brandstetter, Paula Corcuera-Elosegui, Mario Gorenjak, Susanne Harner, Simone Hashimoto, Anna M. Hedman, Michael Kabesch, Gerard H. Koppelman, Javier Korta-Murua, Aletta D. Kraneveld, Anne H. Neerincx, Mariëlle W. Pijnenburg, Maria Pino-Yanes, Uroš Potočnik, Olaia Sardón-Prado, Susanne J.H. VijverbergChristine Wolff, Mahmoud I. Abdel-Aziz, Anke H. Maitland-van der Zee*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Background: Uncontrolled pediatric asthma has a large impact on patients and their caregivers. More insight into determinants of uncontrolled asthma is needed. We aim to compare treatment regimens, inhaler techniques, medication adherence and other characteristics of children with controlled and uncontrolled asthma in the: Systems Pharmacology approach to uncontrolled Paediatric Asthma (SysPharmPediA) study. Material and methods: 145 children with moderate to severe doctor-diagnosed asthma (91 uncontrolled and 54 controlled) aged 6–17 years were enrolled in this multicountry, (Germany, Slovenia, Spain, and the Netherlands) observational, case-control study. The definition of uncontrolled asthma was based on asthma symptoms and/or exacerbations in the past year. Patient-reported adherence and clinician-reported medication use were assessed, as well as lung function and inhalation technique. A logistic regression model was fitted to assess determinants of uncontrolled pediatric asthma. Results: Children in higher asthma treatment steps had a higher risk of uncontrolled asthma (OR (95%CI): 3.30 (1.56–7.19)). The risk of uncontrolled asthma was associated with a larger change in FEV1% predicted post and pre-salbutamol (OR (95%CI): 1.08 (1.02–1.15)). Adherence and inhaler techniques were not associated with risk of uncontrolled asthma in this population. Conclusion: This study showed that children with uncontrolled moderate-to-severe asthma were treated in higher treatment steps compared to their controlled peers, but still showed a higher reversibility response to salbutamol. Self-reported adherence and inhaler technique scores did not differ between controlled and uncontrolled asthmatic children. Other determinants, such as environmental factors and differences in biological profiles, may influence the risk of uncontrolled asthma in this moderate to severe asthmatic population.

Original languageEnglish
Article number106360
Number of pages8
JournalEuropean Journal of Pharmaceutical Sciences
Publication statusPublished - 1-Feb-2023


  • Adherence
  • Asthma control
  • Inhaler technique
  • Medication
  • Pediatric asthma
  • Uncontrolled asthma


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