Related Experiment Videos
Asthma medication use and disease burden in children in a primary care population
Paula Lozano1, Jonathan A Finkelstein, Julia Hecht
1Center for Health Studies, Group Health Cooperative, 1730 Minor Ave, Suite 1600, Seattle, WA 98101, USA. plozano@u.washington.edu
Insights
Many children with persistent asthma do not use controller medications as prescribed and overuse reliever medications, leading to inadequate asthma control. This highlights a need for improved asthma management strategies in pediatric populations.
Area of Science:
- Pediatric Pulmonology
- Respiratory Medicine
- Public Health
Background:
- Persistent asthma in children is often undertreated with controller medications and overtreated with relievers.
- Understanding medication regimens, adherence, and control is crucial for effective pediatric asthma management.
Purpose of the Study:
- To describe asthma medication use and disease burden in children with persistent asthma.
- To evaluate adherence to national guidelines for controller and reliever medication use.
- To estimate the level of asthma control achieved in this pediatric cohort.
Main Methods:
- Cross-sectional cohort study involving 638 children aged 3–15 years with asthma.
- Data collected from 42 primary care practices across three US regions.
- Face-to-face questionnaires assessed symptom-days, medication use, and asthma control.
Main Results:
- Two-thirds of children experienced 0–4 symptom-days in the prior two weeks.
- One-third of children using relievers exhibited high usage patterns.
- One-third of children using controller medications did so infrequently (≤4 days/week).
- Nearly two-thirds of children with persistent asthma indicators had inadequate control, irrespective of controller prescription.
Conclusions:
- Inappropriate reliance on reliever medications and poor adherence to controller medications are prevalent in this insured pediatric population.
- Inadequate asthma control is common, even when controller medications are prescribed, indicating significant management gaps.
Background:
Children with persistent asthma underuse controller medications and overuse relievers. A better understanding of the appropriateness of regimens, medication adherence, and adequacy of asthma control is needed.
Objectives:
To describe use of asthma medications and disease burden in children with persistent asthma, to determine whether use of controllers and relievers is consistent with national guidelines, and to estimate adequacy of asthma control.
Design:
Cross-sectional cohort study.
Setting:
Forty-two primary care practices participating in 3 regions of the United States.
Participants:
Parents of 638 children aged 3 to 15 years with asthma.
Main Outcomes Measures:
Asthma symptom-days, use of reliever and controller medications, and adequacy of asthma control, ascertained by face-to-face questionnaire.
Results:
The mean age was 9.4 years, and 59.9% were boys. In the preceding 2 weeks, two thirds (67.5%) of subjects had 0 to 4 symptom-days, 15.8% had 5 to 9 symptom-days, and 16.6% had 10 to 14 symptom-days (percentages do not total 100 because of rounding). One third (32.6%) of children using relievers had high levels of use. One third (34.3%) of children using controllers used them 4 or fewer days per week. Among children with some evidence of persistent disease (use of controllers, excess symptoms, or excess reliever use), almost two thirds (64.3%) were inadequately controlled. This group consisted both of children reportedly using controllers less than recommended and those reporting not receiving controller medication at all.
Conclusions:
In this insured population, inappropriate reliance on relievers and nonadherence to controllers were common. Inadequate asthma control was common regardless of whether controllers were prescribed.