Status of asthma control in children and the effect of parents' knowledge, attitude, and practice (KAP) in China: a multicenter study

Zhao, Jing; He, Qianqian; Zhang, Guoqing; Chen, Qiyi; Bai, Juan; Huang, Ying; Chen, Qiang; Chen, Ni; Huang, Suli; Tang, Suping; Li, Yun; Zheng, Huacheng; Boping, Bin; Chen, Shi; Zhu, Xiaoping; Liu, Changshan; Zhang, Shanmei; Zhang, Yajing; Zhou, Xiaoqin; Lin, Ren; Shi-wu, Zhao; Hao, Chuangli; Li, Mengrong; Sun, Jun; Li, Lili; Fen-hua, Chen; Shen, Zhen; Hou, Wei; Cheng, Huanji; Gao, Yun; Ding, Mingjie; Huang, Yan; Ya-zhen, Shang; Chen, Yaping; Cao, Lu; Cheng, Li; Wang, Cilin

doi:10.1016/j.anai.2012.07.005

Cited by 30 publications

(37 citation statements)

References 12 publications

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“…38 Similarly, caregiver report of more non-adherence was associated with more ED visits for children who had asthma. 39 In contrast, a third study using a self-report measure of adherence found no relationship between non-adherence and ED visits when included in a multivariate model. 40 Medication Non-Adherence and Outpatient Visits…”

Section: Medication Non-adherence and Ed Visitsmentioning

confidence: 97%

“…36 Caregiver self-reports of non-adherence to corticosteroids were associated with more hospitalizations in a sample of children who had asthma. 39 In another sample, however, a composite score comprised of asking caregivers yes/no questions related to their adherence to filling prescriptions, giving more/less medication than prescribed, and obtaining recommended devices yielded no relation to whether the child was hospitalized in the past 9 months. 41 In a sample of adolescents and young adults who had type 1 diabetes, nonadherence was associated with increased odds for admission for diabetic ketoacidosis and other diabetes-related complications.…”

Section: Medication Non-adherence and Hospitalizationsmentioning

confidence: 99%

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Medication Adherence and Health Care Utilization in Pediatric Chronic Illness: A Systematic Review

2013

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BACKGROUND AND OBJECTIVE: Advanced understanding of modifiable predictors of health care use in pediatric chronic illness is critical to reducing health care costs. We examined the relationship between medication non-adherence and health care use in children and adolescents who have a chronic medical condition. METHODS:A systematic review of articles by using PubMed, PsycINFO, and CINAHL was conducted. Additional studies were identified by searching reference sections of relevant manuscripts. Studies that tested the relationship between medication non-adherence and health care use (ie, hospitalizations, emergency department visits, outpatient visits) or cost in children and adolescents (mean age #18 years) who have a chronic medical condition were included. Extraction of articles was completed by using predefined data fields. RESULTS:Ten studies met our inclusion criteria. Nine of the 10 studies reviewed (90%) demonstrated a relationship between medication nonadherence and increased health care use. The directionality of this relationship varied depending on the outcome variable of interest. FUNDING:The design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation of the manuscript were supported in part by grant T32HD068223 for Dr McGrady. Dr Hommel is funded in part by R01HD067174. Funded by the National Institutes of Health (NIH). POTENTIAL CONFLICT OF INTEREST:The authors have indicated they have no potential conflicts of interest to disclose. 730McGRADY and HOMMEL by guest on May 11, 2018 http://pediatrics.aappublications.org/ Downloaded from In 2010, the United States spent $2.6 trillion on health care, an increase of 3.9% from 2009, and 17.9% of its gross domestic product. 1 Hospital care and physician and clinical services (ie, emergency department [ED] visits, hospitalizations, and office visits, hereafter defined as "health care use") are the 2 largest components of health care spending, 2,3 and accounted for over 50% of the growth in health care spending from 2009 to 2010. 1 Continued rising health care costs despite the recession, the increasing US national deficit, and the increasing percentage of US health spending financed by the government ($1.2 trillion, 45% of all US health spending) have prompted investigation of modifiable factors to reduce health care use and associated costs. 4 Although there is no single strategy for effectively controlling costs, researchers have begun to focus on the 83% of health care resources consumed by individuals who have a chronic medical condition. 4,5 The number of children and adolescents diagnosed with a chronic medical condition has been steadily increasing over the past 20 years, 6 driven in part by increases in the prevalence of obesity 7 and asthma 8 as well as advances in medical care that increase survival (eg, cystic fibrosis, kidney transplant). 9,10 Increases in the prevalence of chronic medical conditions have only increased the already disproportionate health care expenses accounted for...

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Section: Medication Non-adherence and Ed Visitsmentioning

confidence: 97%

Section: Medication Non-adherence and Hospitalizationsmentioning

confidence: 99%

Medication Adherence and Health Care Utilization in Pediatric Chronic Illness: A Systematic Review

2013

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“…Poorer adherence rates correlate to increased GP visits,27 44 attendances at emergency departments17 27 45–48 and hospital admissions 27 45 48 49. However, of the nine studies reviewed, only two17 27 used electronic monitoring to assess adherence, potentially decreasing the validity of the outcomes.…”

Section: What Are the Consequences Of Non-adherence?mentioning

confidence: 99%

Adherence in childhood asthma: the elephant in the room

Morton

Everard

Elphick

2014

Archives of Disease in Childhood

145

104

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Adherence to inhaled steroids is suboptimal in many children with asthma and can lead to poor disease control. Many previous studies in paediatric populations have used subjective and inaccurate adherence measurements, reducing their validity. Adherence studies now often use objective electronic monitoring, which can give us an accurate indication of the extent of non-adherence in children with asthma. A review of the studies using electronic adherence monitoring shows that half of them report mean adherence rates of 50% or below, and the majority report rates below 75%. Reasons for non-adherence are both intentional and non-intentional, incorporating illness perceptions, medication beliefs and practical adherence barriers. Interventions to improve adherence in the paediatric population have had limited success, with the most effective containing both educational and behavioural aspects.

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“…The success of this approach has been illustrated in various Most surveyed PRMs (70%) indicated that the estimated percentage of diagnosed AR comorbidity among asthmatic patients was below 41%, which is higher than the 38.3% comorbidity reported in Japan 23 and the 20% to 40% reported in Turkey, 24 but lower than the 59.5% AR comorbidity observed in Chinese children. 6 Furthermore, our recent outpatient survey showed that 69.9% of asthmatic patients had ARIA-defined AR symptoms. 4 Thus, the prevalence of diagnosed asthma-AR might be underestimated in China.…”

Section: Discussionmentioning

confidence: 99%

“…The difference between theory and prescription behavior of leukotriene modifiers may be caused, in part, by a lower concern for side effects from leukotriene modifiers than the concern of corticosteroid side effects among physicians, patients, and parents. 6 Furthermore, the prescription choices in this survey likely underestimate the number of medication combinations prescribed by physicians because primary care practitioners had listed more than 450 combinations for the treatment of severe AR in the absence of asthma, the most frequent combination being an oral antihistamine with an intranasal corticosteroid. 10 This study has limitations that warrant further discussion.…”

Section: Discussionmentioning

confidence: 99%

Asthma with allergic rhinitis management in China: a nationwide survey of respiratory specialists at tertiary hospitals

Lin

Liu

et al. 2014

Int Forum Allergy Rhinol

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Status of asthma control in children and the effect of parents' knowledge, attitude, and practice (KAP) in China: a multicenter study

Cited by 30 publications

References 12 publications

Medication Adherence and Health Care Utilization in Pediatric Chronic Illness: A Systematic Review

Medication Adherence and Health Care Utilization in Pediatric Chronic Illness: A Systematic Review

Adherence in childhood asthma: the elephant in the room

Asthma with allergic rhinitis management in China: a nationwide survey of respiratory specialists at tertiary hospitals

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