Comparing inhaled medications reported by adolescents with persistent asthma and their caregivers

Objectives: To compare concordance (agreement) between teens with persistent asthma and their caregivers on the reported number of inhaled asthma medications used (rescue and controller); examine concordance specific to controller medications; and determine whether concordance over controller medications within caregiver/teen dyads is associated with demographics or clinical outcomes.Methods: We used baseline data from the School-Based Asthma Care for Teens (SB-ACT) trial in urban Rochester, NY. Caregivers and teens (12-16 yrs.) with poorly controlled persistent asthma separately reported the teens' inhaled therapy, and could name up to two rescue and two controller medications. We compared the total number of medications and number of controller medications reported by each dyad member with Cohen's Kappa, and assessed whether concordance over the number of controller medications was associated with demographics, symptoms, or healthcare utilization using chi-square and t-tests.Results: Of 210 dyads (79% public health insurance, 61% Black teens), 132 (63%) were disconcordant in reporting the overall number of inhaled medications. Teens or caregivers from 173 dyads (82%) reported any controller medication; however, a majority (61%) were discordant in the reporting of controller medications. Compared with concordant dyads, fewer caregivers from dyads with controller medication discordance reported education past high school (35% vs. 51%, p = 0.04); no other differences in demographics, symptoms, or healthcare utilization were identified based on controller medication concordance.Conclusions: Most dyads identified different numbers of inhaled medications, with substantial disagreement over controller medications. Working to ensure a basic understanding of treatment plans may promote successful self-management in persistent childhood asthma.