These findings confirm a relationship between medication beliefs and adherence among parents of children with asthma. A better understanding of parents' medication beliefs and their impact on adherence may help clinicians counsel effectively to promote adherence.
To evaluate the impact of the School-Based Asthma Therapy trial on asthma symptoms among urban children with persistent asthma.Design: Randomized trial, with children stratified by smoke exposure in the home and randomized to a schoolbased care group or a usual care control group.
Rasagiline is effective as monotherapy for patients with early PD. The 2 dosages in this trial were both effective relative to placebo. Further study is warranted to evaluate the longer-term effects of rasagiline in PD.
Measuring the quality of life of caregivers is important for interventions designed for young children with asthma. However, little is known about the impact of childhood asthma on parental quality of life for certain subgroups. This study included the families of young urban children with mild persistent to severe persistent asthma. The goal was to evaluate the relationship between caregivers' quality of life and the children's asthma severity, and to consider the influence of sociodemographic factors on the caregivers' quality of life. Children age 3-7 years (63% male, 59% Black, 75% Medicaid), with mild persistent to severe persistent asthma, were identified from a school-based screening survey. Caregiver quality of life was assessed at baseline and at the end of the study using the Paediatric Asthma Caregiver's Quality of Life Questionnaire (PACQLQ). Pearson correlation coefficients were used to assess the relationship between the PACQLQ and parent-reported asthma symptoms during the same time period. For all measures of severity, there was a significant correlation with quality of life (range r=0.23-0.51, all p<.01). Improvements in the PACQLQ correlated with decreases in symptom scores including symptom days (r=-0.27, p<.001) and symptom nights (r=-0.22, p=.005). In a multivariate model, Hispanic ethnicity, the use of daily maintenance medications, and exposure to secondhand smoke independently predicted worse quality of life scores. We conclude that the caretaker's quality of life, as assessed by the PACQLQ, is directly influenced by the child's asthma severity as well as other family factors among a group of young urban children with significant asthma.
Most children in this study were not accurately classified by their providers as having mild persistent to severe persistent asthma and had not been prescribed maintenance medications. When providers were aware of their patient's asthma symptoms, most of the children were prescribed maintenance medications. Attempts to improve adherence to asthma guidelines should take into consideration provider underestimations of asthma severity.
School-based provision of inhaled corticosteroids significantly improved symptoms, quality of life, and absenteeism among urban children with mild persistent to severe persistent asthma. This effect was seen only among children not exposed to secondhand smoke.
Little is known about the resources urban caregivers of children with asthma use to obtain health information. We analyzed data for 304 families of children with persistent asthma to describe: 1) sources of health information, 2) access and use of Internet resources, and 3) the association between caregiver’s health literacy (HL) and use of health information sources. Overall, 37% of caregivers had Limited HL. Most families received health information from: a health care professional (94%); written sources (51%); family/friends (42%); non-print media (34%); and Internet (30%). Less than ½ of caregivers had access to Internet at home, but 73% reported Internet use in the past year. Caregivers with Adequate HL were more likely to obtain information from multiple sources, and to use and have access to the Internet. Our results suggest that HL is associated with where caregivers obtain health information for their children and their use of the Internet.
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