PURPOSE: To investigate whether the socioeconomic status of children and adolescents with asthma is associated with optimal use of asthma medications in a health care system that provides free access to prescribed medications. METHODS: A cohort of 29,018 children (5-12 y) and adolescents (13-17 y) with asthma was reconstructed from the administrative health database of the Régie de l'assurance maladie du Québec in Canada. Adherence to the Canadian Asthma Guidelines was compared between low-income patients (patients living in families receiving social assistance) and higher-income patients (patients living in middle-class families with working parents). Both groups of patients had free, universal access to medical care and prescribed medications. Patients were considered adherent if they had: (1) 10 doses or fewer of a short-acting beta2-agonist (SABA) per week or (2) greater than 10 doses of a SABA per week plus greater than 1,000 microg of beclomethasone chlorofluorocarbon (CFC) per day. A second definition of adherence was used in which the 10 doses of SABA were replaced by 3 doses. RESULTS: Our cohort comprised 7,454 adolescents and 21,564 children. Within each definition, low-income adolescents had similar rates of adherence as higher-income adolescents (p = .08-.4). Low-income children, however, had lower rates of adherence than higher-income children when the first definition of adherence was used (76% vs. 80%; p < .001). CONCLUSION: Our study showed that socioeconomic status had a small influence on the likelihood of receiving treatment in adherence with the Canadian Asthma Guidelines among children, whereas no association was detected among adolescents.
PURPOSE: To investigate whether the socioeconomic status of children and adolescents with asthma is associated with optimal use of asthma medications in a health care system that provides free access to prescribed medications. METHODS: A cohort of 29,018 children (5-12 y) and adolescents (13-17 y) with asthma was reconstructed from the administrative health database of the Régie de l'assurance maladie du Québec in Canada. Adherence to the Canadian Asthma Guidelines was compared between low-income patients (patients living in families receiving social assistance) and higher-income patients (patients living in middle-class families with working parents). Both groups of patients had free, universal access to medical care and prescribed medications. Patients were considered adherent if they had: (1) 10 doses or fewer of a short-acting beta2-agonist (SABA) per week or (2) greater than 10 doses of a SABA per week plus greater than 1,000 microg of beclomethasone chlorofluorocarbon (CFC) per day. A second definition of adherence was used in which the 10 doses of SABA were replaced by 3 doses. RESULTS: Our cohort comprised 7,454 adolescents and 21,564 children. Within each definition, low-income adolescents had similar rates of adherence as higher-income adolescents (p = .08-.4). Low-income children, however, had lower rates of adherence than higher-income children when the first definition of adherence was used (76% vs. 80%; p < .001). CONCLUSION: Our study showed that socioeconomic status had a small influence on the likelihood of receiving treatment in adherence with the Canadian Asthma Guidelines among children, whereas no association was detected among adolescents.
Authors: Wendy Landier; Cynthia B Hughes; Evelyn R Calvillo; Nancy L R Anderson; Deborah Briseño-Toomey; Leticia Dominguez; Alex M Martinez; Cara Hanby; Smita Bhatia Journal: J Pediatr Oncol Nurs Date: 2011-06-08 Impact factor: 1.636
Authors: Mary E Bollinger; Kim E Mudd; Adam Boldt; Van Doren Hsu; Mona G Tsoukleris; Arlene M Butz Journal: Ann Allergy Asthma Immunol Date: 2013-07-21 Impact factor: 6.347