Introduction and background: Different guidelines for asthma management recommend, prior to establishing additional therapeutic behaviors, confirming the correct use and adherence to the prescribed treatment. Evidence exists on the use of exhaled nitric oxide levels (FeNO) in patients with Th2-mediated asthma for the monitoring of adherence to inhaled corticosteroids. 

Aims and objectives:  To establish whether there is a correlation between FeNO and level of adherence to inhaled corticosteroids in pediatric patients diagnosed with asthma.

Methods: Cross-sectional study including asthma patients between 5 and 18 years of age, attending follow-up at Hospital Militar Central (HMC) between May and November 2022 in Bogotá, Colombia. The study was approved by the HMC?s ethics committee. An initial sociodemographic survey was carried out, followed by an adherence questionnaire (PIAQ), previously validated in our population. FeNO values were quantified with NObreath©. For the descriptive and bivariate statistical analysis, SPSS v.29© was used. STATA© was used for the multivariate analysis.

Results: Eighty-two patients with a median age of 10 years were included, 48.8% women. According to self-report of good adherence defined by the PIAQ questionnaire, 68.3% (n=56) reported good adherence, while 69.5% (n=57) reported adequate control of the disease.  Poor adherence was higher in patients with FeNO >20ppb (p=0.012). In the multivariate analysis, FeNO ?20ppb was significantly associated with better adherence (p=0.02).

Conclusions: FeNO can be a useful tool in the follow-up of pediatric patients with asthma and to evaluate adherence to inhaled corticosteroids.