Preschool children with high adherence to inhaled corticosteroids for asthma do not show behavioural problems

Aim: To assess prevalence of behavioural problems in preschool children with asthma with electronically verified exposure to inhaled corticosteroids (ICS). Methods: Cross-sectional study of 81 children 25 years of age using daily ICS for persistent asthma. During 3 months follow-up, adherence to ICS treatment was recorded by an electronical logging device (Smartinhaler (R)). Parents completed the Child Behavior Checklist 1.55 years (CBCL 1.55) to assess behavioural problems; results were compared to a published reference group of healthy children. Results: The median (interquartile range) adherence to ICS was 92 (7897) %. There was no difference in total CBCL score between children with asthma on ICS (mean, [SD] 32.10 [1.99]) and the reference group (33.30 [1.87], 95% CI for difference -6.62 to 4.22). Children with asthma were more likely to have somatic complaints (95% CI for difference 0.64 to 1.96) and less likely to have anxious/depressive symptoms (95% CI for difference -1.57 to -0.25) than the reference group. CBCL scores were not significantly related to the electronically measured adherence rates. Conclusions: Maintenance treatment with ICS, taken daily as prescribed, is not associated with an increased risk of behavioural problems in preschool children.