Trends in Preventive Asthma Medication Use Among Children and Adolescents, 1988–2008

Abstract

Between 1988 and 2008, the use of PAM increased among children with current asthma. Non-Hispanic black and Mexican American children, adolescents aged 12 to 19 years, and uninsured children with current asthma had lower use of PAM.

Preventive asthma medication discontinuation among children enrolled in fee-for-service Medicaid

“…Covariates were chosen that have been found in other research to be predictive of discontinuation: age at first preventive asthma medication claim, sex [9,[34][35][36][37][38][39][40], race/ ethnicity [4,9,10,21,38,41], urbanicity [41], geographic location [9], reported highest educational attainment by any family member [35,37,39,42], family structure [39,40,43], reported health status [9], presence of chronic conditions besides asthma [7,35], healthcare out-of-pocket costs [12], presence of a primary care provider [5,6], and preventive asthma medication regimen [7,20,36].…”

“…Preventive asthma medications are a cornerstone of preventive treatment to reduce morbidity and adverse outcomes, and include inhaled corticosteroids (ICS), longacting b 2 -agonists, leukotriene modifiers, mast cell stabilizers, and monoclonal antibodies [3,4].…”

“…Unfortunately, under-use and discontinuation of preventive asthma medications are widespread among US children [4][5][6][7] and lead to potentially avoidable exacerbations, greater use of rescue medications, emergency room visits, and hospitalizations [2,7]. Despite recent evidence that use of preventive asthma medications is generally increasing among children nationwide [4], socially disadvantaged children, and racial/ ethnic minority groups [2,8], who are most likely to be enrolled in Medicaid and the Children's Health Insurance Program (CHIP) [5,9], still have the lowest rates of use [4,8,10].…”

“…Despite recent evidence that use of preventive asthma medications is generally increasing among children nationwide [4], socially disadvantaged children, and racial/ ethnic minority groups [2,8], who are most likely to be enrolled in Medicaid and the Children's Health Insurance Program (CHIP) [5,9], still have the lowest rates of use [4,8,10].…”

Anti-asthmatic prescription variability in children according to age

“…6,12,16,22,23 In relation to maintenance treatment in other countries, inhaled corticosteroids as a single agent is generally the most prescribed subgroup, as recommended in the guidelines, followed by leukotriene receptor antagonists in second or third place. Although the prescription of montelukast is high in some countries 2,9,11,23 and almost absent in others, 6,12,17,27 which may be related to the differences at the time of the study, the population age or the prescription control has specific rules in each country.…”