Symptom control and medication adherence in Japanese pediatric and adolescent asthma: A large-scale web-based cross-sectional survey

Pediatric asthma remains a significant public health concern in Japan, where adherence to updated treatment guidelines and consistent medication use is inconsistent. This study aimed to evaluate current pediatric asthma management practices and identify areas for improvement to inform future strategies. A nationwide, web-based cross-sectional survey was conducted among caregivers of children and adolescents aged 0-19 years diagnosed with asthma and receiving care at medical institutions across Japan. The survey assessed asthma control levels and examined factors such as medication adherence, environmental exposures, and coexisting allergic diseases. Among all participants (n = 2000), 65.8 % were on some treatment regimen, but many patients were not receiving continuous guideline-based treatment. Adherence to inhaled medications, especially corticosteroids, was low. Despite treatment, 26.2 % of patients had poor asthma control, particularly among children aged 0-3 years. Poor control was significantly associated with comorbid allergic conditions, such as allergic rhinitis, hay fever, atopic dermatitis, pet ownership, and a family history of asthma. The findings highlight persistent challenges in pediatric asthma management, particularly among young children. Although asthma treatment is widely prescribed, many patients remain uncontrolled. Coexisting allergic diseases play a crucial role in asthma control. Improving asthma management requires enhanced patient education, adherence to treatment guidelines, and addressing coexisting conditions. Additionally, improving pet ownership environments is critical, as it is associated with poor asthma control. To enhance asthma control, it is also necessary to monitor medication adherence and assess inhaler techniques.