Parental Beliefs About Medications and Medication Adherence Among Urban Children With Asthma

Conn, Kelly M.; Halterman, Jill S.; Fisher, Susan G.; Yoos, H. Lorrie; Chin, Nancy P.; Szilâgyi, Peter G.

doi:10.1367/a05-004r1.1

Cited by 134 publications

(103 citation statements)

References 28 publications

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“…Repeat ED visits for asthma have been associated with families lacking confidence in the efficacy of asthma medications and not using criteria in deciding to seek emergency care. 21,22 The proportion of children with EIW in this study who had taken controller medications in the past year (41%) may be consistent with current National Heart, Lung, and Blood Institute guidelines, or even high, given their relatively mild disease. 6 However, one-third of children with an EIW episode in the past year had not used a bronchodilator, which is not in keeping with current guidelines.…”

Section: Discussionsupporting

confidence: 60%

Exercise-Induced Wheeze, Urgent Medical Visits, and Neighborhood Asthma Prevalence

et al. 2013

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OBJECTIVE: Exercise-induced wheeze (EIW) may identify a distinct population among asthmatics and give insight into asthma morbidity etiology. The prevalence of pediatric asthma and associated urgent medical visits varies greatly by neighborhood in New York City and is highest in low-income neighborhoods. Although increased asthma severity might contribute to the disparities in urgent medical visits, when controlling for health insurance coverage, we previously observed no differences in clinical measures of severity between asthmatic children living in neighborhoods with lower (3%–9%) versus higher (11%–19%) asthma prevalence. Among these asthmatics, we hypothesized that EIW would be associated with urgent medical visits and a child’s neighborhood asthma prevalence. METHODS: Families of 7- to 8-year-old children were recruited into a case-control study of asthma through an employer-based health insurance provider. Among the asthmatics (n = 195), prevalence ratios (PRs) for EIW were estimated. Final models included children with valid measures of lung function, seroatopy, and waist circumference (n = 140). RESULTS: EIW was associated with urgent medical visits for asthma (PR, 2.29; P = .021), independent of frequent wheeze symptoms. In contrast to frequent wheeze, EIW was not associated with seroatopy or exhaled NO, suggesting a distinct mechanism. EIW prevalence among asthmatics increased with increasing neighborhood asthma prevalence (PR, 1.09; P = .012), after adjustment for race, ethnicity, maternal asthma, environmental tobacco smoke, household income, and neighborhood income. CONCLUSIONS: EIW may contribute to the disparities in urgent medical visits for asthma between high- and low-income neighborhoods. Physicians caring for asthmatics should consider EIW an indicator of risk for urgent medical visits.

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Section: Discussionsupporting

confidence: 60%

Exercise-Induced Wheeze, Urgent Medical Visits, and Neighborhood Asthma Prevalence

et al. 2013

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“…13 Previous studies have revealed this scale to have good reliability in adults with chronic diseases (Cronbach's a = 0.60-0.83) 20 and in urban children with asthma (Cronbach's a = 0.78). 21 The scale includes questions based on a 5-point likert scale, such as "I sometimes alter the dose of my child's medication to suit their needs" and "Some people forget to give their child his/her medications, how often does this happen to you? "…”

Section: Data Collectionmentioning

confidence: 99%

Complementary and Alternative Medicine Use and Adherence With Pediatric Asthma Treatment

Philp¹,

Maselli

Pachter

et al. 2012

Pediatrics

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BACKGROUND AND OBJECTIVE: Complementary and alternative medicine (CAM) use for pediatric asthma is increasing. The authors of previous studies linked CAM use with decreased adherence to conventional asthma medicines; however, these studies were limited by cross-sectional design. Our objective was to assess the effect of starting CAM on pediatric adherence with daily asthma medications. METHODS: We used a retrospective cohort study design. Telephone surveys were administered to caregivers of patients with asthma annually from 2004 to 2007. Dependent variables were percent missed doses per week and a previously validated “Medication Adherence Scale score.” Independent variables included demographic factors, caregiver perception of asthma control, and initiation of CAM for asthma. We used multivariate linear regression to assess the relationship between medication adherence and previous initiation of CAM. RESULTS: From our longitudinal data set of 1322 patients, we focused on 187 children prescribed daily medications for all 3 years of our study. Patients had high rates of adherence. The mean percent missed asthma daily controller medication doses per week was 7.7% (SD = 14.2%). Medication Adherence Scale scores (range: 4–20, with lower scores reflecting higher adherence) had an overall mean of 7.5 (SD = 2.9). In multivariate analyses, controlling for demographic factors and asthma severity, initiation of CAM use was not associated with subsequent adherence (P > .05). CONCLUSIONS: The data from this study suggest that CAM use is not necessarily “competitive” with conventional asthma therapies; families may incorporate different health belief systems simultaneously in their asthma management. As CAM use becomes more prevalent, it is important for physicians to ask about CAM use in a nonjudgmental fashion.

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“…Parents may stop the daily inhaler for the child when their child feels better, thinking that will prevent the adverse reactions of medication. [10] Compliance is better for short-term treatments and tends to decline over time, which can be especially problematic when managing chronic conditions. [11] More complicated regimens also lead to decreased compliance, and patients on a single medication are more likely to be compliant than those on multiple medications.…”

Section: Reasons/barriers For Noncompliancementioning

confidence: 99%

Medication compliance among children

2010

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Parental Beliefs About Medications and Medication Adherence Among Urban Children With Asthma

Cited by 134 publications

References 28 publications

Exercise-Induced Wheeze, Urgent Medical Visits, and Neighborhood Asthma Prevalence

Exercise-Induced Wheeze, Urgent Medical Visits, and Neighborhood Asthma Prevalence

Complementary and Alternative Medicine Use and Adherence With Pediatric Asthma Treatment

Medication compliance among children

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