Parental fears about side effects are keeping preventive medications from most asthmatic children, a recent survey finds.

Although almost three out of four parents strongly agreed that they trusted the doctor’s judgment, only 14% said they completely adhered to prescribed regimens. That’s because many parents believe the medications were either not essential or were even dangerous (Pediatrics. 2007;120:e521-e526).

“Some parents hear or read the word ‘steroid’ and at once start worrying about the long-term effects on their child,” explains lead author Kelly M. Conn, MPH, of the University of Rochester Medical Center in New York. They confuse inhaled corticosteroids with the anabolic steroids athletes use and abuse to enhance their performances.

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In order to improve the “strikingly low proportion” of compliant parents, health-care providers should take extra care to explain that corticosteroids and other asthma medicines are quite safe when used properly, Conn advises. “The more parents hear that, the more they understand, the less room there is for anxiety.”

Parents must also be taught that unlike rescue drugs, preventive medications must be taken consistently, whether the child is symptomatic or not. “Children today can be virtually symptom-free, thanks to modern preventive medications,” Conn observes. “But kids rely on their parents to make health decisions for them, so we need to know what parents are thinking as we partner with them to achieve this goal.”