Adolescents and Asthma Medication Compliance
- Friday, September 18, 2009, 12:41
- Asthma
- 662 views
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- Nicole:
- My son’s been taking the Becotide since he was a little boy – he’s now seventeen. While I was gone, he went to camp, and forgot to take along his Becotide. The camp was about four or five days long, and when he came home, he thought to himself, “Well if I can do without the Becotide for four or five days, then I don’t need it.” He hasn’t been taking it – and that was seven months ago – and I just found this out.
- Dr. Redding:
- And you’re concerned.
- Nicole:
- I think so, because his doctor, in Australia, basically told him that he is to take it every day, one puff every day to help prevent asthma. David has not taken it for at least six, seven months and he’s only just told me. He did it without consulting anybody in the medical field, and I don’t know whether that’s wise.
- Dr. Redding:
- Does he have a good rapport with his physician?
- Nicole:
- He had a wonderful rapport, but Dr. Wilke ended up going somewhere else. And since then, my son hasn’t been to any doctor.
- Dr. Redding:
- Well, let me tell you a few things. Children who have asthma that starts from the time they are a couple years old and lasts until they’re adolescent are likely to have asthma throughout much of their life – he will probably have some asthma as an adult. Now your child is in that minority that has actually taken their medicines on a regular basis and minimized the severity of asthma. So I would first tell you, you’ve done a great job in terms of managing his asthma.
Number two is that one of the ways that adolescents become more normal is if they don’t take their medicines in front of other adolescents. There’s a great tendency among teenagers to not take their medicines because they’re fine, they feel fine, they won’t have long-term effects – and, “don’t bother me.”
- Nicole:
- Right, right. That’s exactly what he’s done.
- Dr. Redding:
- That’s an adolescent characteristic. And it’s not unique. At the same time he does that, you have a very bonafide concern that his asthma may get worse. If someone is to stop taking his or her medicines for asthma, in order to do that safely, that child has to be monitored in some way. Now whether you do that with a peak flow machine at home, or whether you do that with a spirometer, which is a formal way of testing lung function in a doctor’s office. It’s important to do this even when he feels fine his lungs are fine.
- Nicole:
- Right, okay.
- Dr. Redding:
- So that one of the first things he needs to do is to see someone who can measure how his lungs work and tell you whether or not his lungs are indeed normal. Now if they are not, then he may need more medicine. Then there becomes an issue as to whether you can convince him to take the medicine consistently- even though it’s inconvenient – under a circumstance where he’s doing it in private. It’s better to do that than to wait for him to get sick.
- Nicole:
- So what you’re telling me is not to force him to take his puffer, but to go to a doctor and get them to speak to him and they check his asthma?
- Dr. Redding:
- Exactly!
- Nicole:
- Okay. I’ve been yelling at him for a couple of days to get back on his Becotide.
- Dr. Redding:
- Well he may need it and you may be absolutely right in your concern.
- Nicole:
- Right. But the best thing is he’s got to go and get somebody to check it.
- Dr. Redding:
- And be monitored. Teenagers tend to deny their symptoms. They cough, but they’re fine – they wheeze, but they’re fine. It’s important to measure how “fine” they feel in a more objective way. If they do that, and his lung function is not normal, then there’s the issue as to when he feels fine he really isn’t. In that circumstance, he needs to take his medicine even though he feels fine. Then, you have to develop the incentives for him to do so.
I can tell you adolescents are a challenge because they don’t tend to take you too seriously.
- Nicole:
- No, they don’t.
- Dr. Redding:
- They don’t take their conditions too seriously and they want to be as normal as possible. That usually happens with someone that they trust, that they like and that is monitoring their asthma more than you can do.
- Nicole:
- He said that he’d listen to what the doctor would say. I told him that I would speak to someone. And he goes, “Alright, you tell me what they say then.”
- Dr. Redding:
- [Laughs] I think it’s a very big deal that he lost his doctor that he trusted. A challenge for him is going to be to find another doctor that he can trust and relate to so he can problem solve with that person rather than with you.
- Nicole:
- Okay, yes.
- Dr. Redding:
- Well I hope that’s helpful.
- Nicole:
- It’s been wonderful! Thank you very much!
- Dr. Redding:
- You’re welcome!
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