Pediatric Inhaled Medication: A Cross-Sectional Analysis on Usage Trends and Parental Perceptions in Romania

Background: Inhaled medications are central in managing pediatric respiratory diseases, yet device complexity and nebulizer use often challenge caregivers and affect adherence. This study assessed current usage patterns and parental perceptions of inhaled therapies in Romania, aiming to identify modifiable factors for targeted education. Methods: A cross-sectional observational survey was distributed via SVC® (Spitalul Virtual pentru Copii – Virtual Children’s Hospital), a widely accessed social media plat-form for Romanian parents. Data included demographics, inhaled medication use, pre-scribing sources, adherence, and treatment perceptions. Results: A total of 1,825 parents participated, mostly urban residents (87.6%). Chronic respiratory disease, mainly asthma, was reported in 7.3% of children. Inhaled therapy was used in 71.9% of cases, predominantly saline solutions, bronchodilators, and corti-costeroids, marking a decline compared with the past decade. Nebulizers (74.1%) were the main devices used. Prescriptions were largely pediatrician-based, though self-medication occurred, particularly with saline solutions, often influenced by non-medical sources (p=0.003). Parents of children with chronic disease were less likely to self-medicate (p=0.042), especially with β-agonists and corticosteroids (p< 0.001). Additionally, 31.3% reported use of complementary remedies, including homeopathy. Overall, 73.5% perceived inhaled therapy as effective, with adverse events reported by only 8.3%. Conclusions: Inhaled therapy remains prevalent in Romanian children, though self-medication and alternative treatments persist, shaped by cultural factors and limited medical education. Parents of children with chronic disease show better adherence and reliance on prescribed therapy. Enhancing parental education via accessible digital platforms may reduce inappropriate practices and improve outcomes in low-resource settings.