Socioeconomic status and medication prescription patterns in pediatric asthma in Canada

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.

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.

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).

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.