Asthma

Evidence: 

Treatment Adherence in Adolescents with Asthma 
Author(s): Alan Kaplan and David Price 

“Patient/Health Care Professionals communication is a key component for effective and comprehensive patient assessment and for tailoring treatment to individual requirements.”

Education:

Asthma is a chronic (lifelong) disease that can be serious, sometimes even life-threatening. This chronic lung disease makes it harder to move air in and out of the lungs. Airways become swollen and inflamed and extra sensitive to things in the environment which trigger asthma.

These triggers can be:

• pollen
• dust mites
• pets
• foods
• cigarette smoke
• respiratory infections
• exercise
• changes in weather, cold or windy conditions
• emotional stress
• pollution

When asthmatics experience a trigger, their airways create more mucous and swell, consequently making it difficult to breathe. Prevention by avoiding triggers is the most important part of asthma treatment.

Some symptoms of asthma are:

• Breathlessness
• Tightness in the chest
• Cough, though a cough alone does not mean asthma
• Wheezing, this is when your child’s breathing sounds like whistle. Not all children who wheeze develop asthma

These can be symptoms of mild asthma and may go away after a few days.

Most asthma episodes are mild, however some adolescents will suffer with severe asthma:

• Struggling to breathe
• Very distressed
• Exhausted or limp
• Deep sucking in action at their throat or chest as they struggle to breathe.

This is severe asthma and will require an ambulance. CALL 000

Asthma in the teenage years is an important issue and it is crucial that is it well managed. For teens who are diagnosed at this age, it can incite strong emotions as they may see that the illness will cause them to feel like their life is no longer normal and that they must be reliant on medical staff and ongoing medication. Their self-esteem may be affected due to the effects that it may have on their social life such as absence from social activities, being treated differently by their peers and being referred to as the ‘the ill person.’ It is important that your teenager’s mental health is monitored, and support sought as necessary.

At this age it is common for teens to not adhere to their medication plan as they may not be fully aware of the dangers of poorly controlled asthma, as up until now parents have often taken responsibility for their treatment. Studies have shown 50% of teens do not adhere to their treatment and tragically more adolescents die of asthma than younger children. It is necessary to find out why your teenager may not be taking their medication and address these issues. Developmental changes, socially and emotionally, may affect compliance by your teen and put them at risk. Some of the reasons that your teen may not be taking medication are:

• Yearning for independence and responsibility
• Unsure over who is responsible for medication, themselves, or parents
• Forgetting due to lack of organisation and poor time management
• Embarrassment in front of peers
• Too busy or lazy
• Claims of lack of effect of the medication

It is important that teens become more independent and may want to take on the responsibility for their medication, however they can forget or feel embarrassed taking it in front of their peers which affects their condition being kept under control. Conversely, some teenagers will still rely heavily on parents and refuse to take responsibility for their own asthma management. For some, the management of a chronic condition can be a burden and an impact on their daily life. It may restrict their social life, may cause more absences from school due to it not being managed effectively, and it can impact their ability to play sport.

Teens may also be less likely to regularly take preventative medication to reduce the incidence of asthma and just rely on medication for the symptoms once they appear.

Your teenager may choose to start work at this age and it is important that they consider any triggers in their workplace such as smoke, chemicals, weather conditions, this will be different for each person.

Empowerment:

Giving your teen some ownership of managing their asthma may help keep their condition under control and reduce flare ups. In consultation with their doctor, suggesting regimes which provide the flexibility of administering their medication at home rather in public may help or offering medications that can be discreetly administered in public. Speak to your child’s doctor about the possibility of this and include your child’s input in their asthma plan. Try setting and implementing goals and treatment plans with your child, whilst considering their schedules and commitments, this will give them some control and will allow them the opportunity to have input rather than feeling like they are being dictated to.   

Electronic monitoring such as smartphone apps may be of benefit and should be discussed with the doctor. These can be useful to remind the teenager to administer medication as well as to track adherence.

The support of friends and peers is a big influence in the teenage years. Finding others with asthma for your teen to chat with may be helpful to share problems, discuss ways of coping and tackling issues that may arise. Parents too can benefit from finding support to help navigate the present and future.

More information can be found at https://asthma.org.au/

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