BACKGROUND: Asthma guidelines advocate inhaled corticosteroids as the cornerstone treatment of persistent asthma, yet several studies report underuse of inhaled corticosteroids in children with persistent asthma. Moreover, few studies use objective pharmacy data as a measure of drug availability of asthma medications. We examined factors associated with the use of inhaled corticosteroids in young underserved children with persistent asthma using pharmacy records as their source of asthma medications. METHODS: This was a cross-sectional analysis of questionnaire and pharmacy record data over a 12-month period from participants enrolled in a randomized clinical trial of a nebulizer educational intervention. RESULTS: Although exposure to > or = 1 inhaled corticosteroids refill was high at 72%, 1 of 5 children with persistent asthma had either no medication or only short-acting beta agonist fills for 12 months. Only 20% of children obtained > or = 6 inhaled corticosteroids fills over 12 months. Obtaining > or = 3 inhaled corticosteroids fills over 12 months was significantly associated with an increase in short-acting beta agonist fills and receiving specialty care in the regression models while controlling for child age, asthma severity, number of emergency department visits, having an asthma action plan, and seeking preventive care for the child's asthma. CONCLUSIONS: Overreliance on short-acting beta agonist and underuse of inhaled corticosteroid medications was common in this group of young children with persistent asthma. Only one fifth of children obtained sufficient controller medication fills.
RCT Entities:
BACKGROUND:Asthma guidelines advocate inhaled corticosteroids as the cornerstone treatment of persistent asthma, yet several studies report underuse of inhaled corticosteroids in children with persistent asthma. Moreover, few studies use objective pharmacy data as a measure of drug availability of asthma medications. We examined factors associated with the use of inhaled corticosteroids in young underserved children with persistent asthma using pharmacy records as their source of asthma medications. METHODS: This was a cross-sectional analysis of questionnaire and pharmacy record data over a 12-month period from participants enrolled in a randomized clinical trial of a nebulizer educational intervention. RESULTS: Although exposure to > or = 1 inhaled corticosteroids refill was high at 72%, 1 of 5 children with persistent asthma had either no medication or only short-acting beta agonist fills for 12 months. Only 20% of children obtained > or = 6 inhaled corticosteroids fills over 12 months. Obtaining > or = 3 inhaled corticosteroids fills over 12 months was significantly associated with an increase in short-acting beta agonist fills and receiving specialty care in the regression models while controlling for child age, asthma severity, number of emergency department visits, having an asthma action plan, and seeking preventive care for the child's asthma. CONCLUSIONS: Overreliance on short-acting beta agonist and underuse of inhaled corticosteroid medications was common in this group of young children with persistent asthma. Only one fifth of children obtained sufficient controller medication fills.
Authors: M Kattan; H Mitchell; P Eggleston; P Gergen; E Crain; S Redline; K Weiss; R Evans; R Kaslow; C Kercsmar; F Leickly; F Malveaux; H J Wedner Journal: Pediatr Pulmonol Date: 1997-10
Authors: Jean-Marie Bruzzese; Cesalie Stepney; Elizabeth K Fiorino; Lea Bornstein; Jing Wang; Eva Petkova; David Evans Journal: J Asthma Date: 2011-12-07 Impact factor: 2.515
Authors: Jerry A Krishnan; Molly A Martin; Cortland Lohff; Giselle S Mosnaim; Helen Margellos-Anast; Julie A DeLisa; Kate McMahon; Kim Erwin; Leslie S Zun; Michael L Berbaum; Michael McDermott; Nina E Bracken; Rajesh Kumar; S Margaret Paik; Sharmilee M Nyenhuis; Stacy Ignoffo; Valerie G Press; Zachary E Pittsenbarger; Trevonne M Thompson Journal: Contemp Clin Trials Date: 2017-03-31 Impact factor: 2.226
Authors: Montserrat M Graves; Christina D Adams; Jade A Bender; Stacey Simon; And Jay M Portnoy Journal: Curr Allergy Asthma Rep Date: 2007-11 Impact factor: 4.806
Authors: Michiko Otsuki; Michelle N Eakin; Cynthia S Rand; Arlene M Butz; Van Doren Hsu; Ilene H Zuckerman; Jean Ogborn; Andrew Bilderback; Kristin A Riekert Journal: Pediatrics Date: 2009-12 Impact factor: 7.124