Exploring the intersection of executive function and medication adherence in school-age children with asthma
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Jennifer Sonney1, Kathleen C Insel2
1a Department of Family and Child Nursing , School of Nursing, University of Washington , Seattle , WA.
Insights
Children with persistent asthma often have lower executive functioning, impacting their ability to adhere to medication. This study highlights the link between executive function skills, like shifting, and medication adherence in pediatric asthma management.
Area of Science:
- Pediatric Pulmonology
- Neuropsychology
- Behavioral Pediatrics
Background:
- Asthma is a prevalent chronic childhood illness, with persistent cases heavily reliant on controller medication adherence for effective management.
- Empowering children in their asthma care necessitates understanding their executive functioning capabilities.
- A knowledge gap exists regarding the executive functions of children diagnosed with asthma.
Purpose of the Study:
- To investigate the interrelation between executive function, asthma status, and medication adherence in school-aged children.
- To explore how specific executive functions correlate with medication adherence in pediatric asthma patients.
Main Methods:
- A cohort of 31 school-aged children (7-11 years) with asthma and their parents participated.
- Data collection included parent-reported asthma control and child-reported asthma control, medication beliefs, and adherence.
- Children completed a comprehensive executive function assessment battery measuring inhibition, updating, shifting, and planning.
Main Results:
- Children with asthma demonstrated significantly lower composite scores in inhibition and shifting compared to a reference sample.
- Hierarchical regression analyses indicated that shifting abilities explained 16% of the variance in child-reported medication adherence, even after controlling for age and asthma control.
Conclusions:
- School-aged children with persistent asthma exhibit diminished executive functioning.
- Executive functioning, particularly shifting abilities, appears closely linked to controller medication adherence in pediatric asthma.
- Further research is warranted to explore the intricate relationship between executive function and medication adherence in managing childhood asthma.
Abstract:
Asthma is one of the most common chronic diseases of childhood. For children with persistent asthma, asthma control is largely related to controller medication adherence. With increasing calls for children to be involved in their own asthma management, there is a gap in our knowledge about the executive functioning of children with asthma.
Objective:
The purpose of this study was to explore the relationship between executive function, asthma, and medication adherence among school-age children with asthma.
Methods:
Thirty-one children ages 7 to 11 years (M = 8.9 ± 1.51) and one of their parents were enrolled in this study. Parents reported on asthma control while children reported on asthma control, medication beliefs, medication adherence, and completed an executive function battery that assessed inhibition, updating, shifting and planning.
Results:
Compared to the reference sample, children in this study had significantly lower composite scores in inhibition, t (31) = -3.84, p =. 001, and shifting, t (30) = -3.73, p =. 001. Controlling for age and asthma control, hierarchical regression analyses revealed that shifting accounted for 16% of the variance in child-reported medication adherence.
Conclusions:
This study revealed lowered executive functioning scores among school-age children with persistent asthma. Furthermore, it appears executive functioning and controller medication adherence are intertwined and warrant future exploration.
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