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Medication adherence in pediatric asthma: reasoning, responsibility, and behavior
Elizabeth L McQuaid1, Sheryl J Kopel, Robert B Klein
1Child Psychiatry, Rhode Island Hospital, 593 Eddy Street, Providence, Rhode Island 02903, USA. emcquaid@lifespan.org
Insights
Child adherence to asthma medication is low at 48%. Older children, despite greater knowledge and responsibility, show poorer adherence. This highlights a gap in pediatric asthma management.
Area of Science:
- Pediatric Pulmonology
- Health Psychology
Background:
- Asthma management in children requires consistent adherence to preventive medication.
- Understanding factors influencing adherence is crucial for improving health outcomes.
Purpose of the Study:
- To evaluate child adherence to preventive asthma medications.
- To explore the relationship between children's asthma knowledge, reasoning, and management responsibility with adherence.
- To determine if adherence correlates with asthma morbidity.
Main Methods:
- 106 children with asthma and their parents participated.
- Medication adherence was tracked electronically for one month.
- Self-report measures and child interviews assessed knowledge and reasoning.
Main Results:
- Children adhered to approximately 48% of prescribed asthma medication doses.
- Adherence was lower in older children, minority groups, and those with higher morbidity.
- Increased age correlated with better asthma knowledge and perceived responsibility, but not adherence.
Conclusions:
- Older children's increased asthma knowledge and responsibility did not translate to better medication adherence.
- No significant association was found between adherence and child's knowledge, reasoning, or management responsibility.
- Current approaches may not effectively link understanding to action in pediatric asthma management.
Objective:
To assess child adherence to preventive asthma medications; to investigate relations between knowledge, reasoning about asthma, and responsibility for management and adherence; and to determine the association between adherence and morbidity.
Methods:
Participants were 106 children with asthma and their parents. Medication adherence was electronically monitored for 1 month. Participants completed self-report measures. Children were interviewed to assess reasoning about asthma.
Results:
Children's adherence was approximately 48% of prescribed doses. Adherence was negatively related to age (r = -.21, p <.05); minority status, F(1, 98) = 7.55, p <.01; and morbidity (r = -.26, p <.01). Age was associated with increased child knowledge (r =.47, p <.001), reasoning about asthma (tau =.23, p <.01), and responsibility for asthma management (r =.44, p <.01). These variables were not associated with adherence.
Conclusions:
Although older children know more about asthma and assume more responsibility for disease management, their adherence is lower than that of younger children. No association was found between adherence and child knowledge, reasoning about asthma, or responsibility for asthma management.
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