Compliance with medical regimens, self-management programs, and self-care in childhood asthma.

Compliance with medical regimens is as poor or poorer in childhood asthma than it is for other chronic illnesses. A spate of self-management programs for childhood asthma has been developed to counteract nonadherence and to enable patients to be more confident and competent in their ability to prevent or control asthmatic episodes. The programs offer promise and report some encouraging results, but the programs are still unproven, and they are neither widely available nor widely used. The individual physician remains the key player in mounting effective self-management programs; but if the physician is to function effectively in this role, drastic changes are called for in the way that both medical practice is conducted and patient-health care provider relationships are managed. Steps and strategies that would help providers establish effective individual self-management programs for asthmatic patients are outlined.