Why do some parents fail to give kids asthma medications?

With asthma medications, three things affect parents' compliance. One is that people don't trust steroids even though they are safe and the most effective medicines we have. Because they don't trust the medications, they don't use them as often as they should, and the lack of effectiveness becomes self-fulfilling.

Next is ease of use. Most people prefer to drive a car with an automatic transmission and not a manual, even if the manual gets better gas mileage. Likewise, the more complicated it is to administer a drug and the more regularly it has to be taken, the less likely a patient will be fully compliant.

Drugs you can take once or twice a day can be left at home and used in the morning or the evening. But more often than that, they have to be carried around. They are easily lost, and of course, your child has to remember to take them.

There may be difficulty in inhaling properly, and finally, with children, there's the all-important criterion: How does it taste? Finally, for parents, there is the matter of cost. Most medicines are covered by insurance, but co-payments increase with nongenerics, and even with low co-payments the bill can add up if several prescriptions are involved.

A newer, easy-to-use powder inhaler like Advair runs about $200 a month so insurance carriers prefer older, harder to-take drugs. All this adds up to an obstacle course that when taken together will sabotage effective treatment, and thus drive people towards cheaper, easier, and possibly crazier alternatives.

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