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Sibship and dispensing patterns of asthma medication in young children-a population-based study
Elin Dahlén1,2, Sara Ekberg1, Cecilia Lundholm1
1Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
Insights
Children with siblings were less likely to receive asthma medication, but persistence increased when sibling medication use was considered, suggesting potential sharing. This impacts understanding pediatric asthma management.
Area of Science:
- Pediatric pharmacology
- Epidemiology
- Public health
Background:
- Asthma medication dispensing patterns in children are influenced by various factors.
- Understanding the impact of sibship on medication adherence is crucial for effective pediatric asthma management.
Purpose of the Study:
- To investigate the association between having siblings and the dispensing patterns of asthma medication in young children.
- To analyze the incidence and persistence of asthma medication dispensing in relation to sibship status, asthma diagnoses, and siblings' medication use.
Main Methods:
- A register-based cohort study of 50,546 children born in Stockholm (2006-2007), followed from 2006 to 2014.
- Utilized a Cox model to assess the association between sibship and asthma medication incidence and persistence.
- Persistence was evaluated using 4- and 18-month time windows, incorporating sibling and control medication data.
Main Results:
- Children with siblings had a lower adjusted hazard ratio (0.85) for dispensed asthma medication compared to singletons.
- Persistence of controller medication was lower in children with siblings (adj. RR 0.72 for 4 months).
- Including siblings' medication data increased the proportion of children with persistent medication, suggesting potential sharing.
Conclusions:
- Sibship status significantly influences asthma medication dispensing patterns in young children.
- The findings suggest that siblings may share asthma medications, impacting observed persistence rates.
- These results highlight the need to consider family dynamics in pediatric asthma treatment strategies.
Purpose:
Our aim was to study the association between sibship and dispensing patterns of asthma medication in young children, focusing on incidence and persistence, and taking sibship status, asthma diagnoses, and siblings' medication into account.
Methods:
A register-based cohort study including all children (n = 50 546) born in Stockholm, Sweden 2006 to 2007, followed up during 2006 to 2014. Exposure was sibling status; outcome was incidence of dispensed asthma medication and persistence over time. A Cox model was used to study the association between sibship and asthma medication. Persistence was defined using two different time windows (4 and 18 months) in a refill sequence model including siblings' and unrelated control children's medication.
Results:
After 1 year of age, the adjusted hazard ratio of dispensed asthma medication was 0.85 (95% CI 0.80-0.90) among children with siblings compared with singletons. The estimated proportion of children with persistent controller medication was 7.2% (4-month model) and 64.5% (18-month model). When including the siblings' controller medication, the estimated proportion was 8.8% (4 months) and 7.8% for control children (relative risk (RR) 0.89, 95% CI 0.81-0.98). The persistence was lower for those with siblings compared with singletons (adj. RR 0.72, 95% CI 0.62-0.85 for 4 months) with similar estimates for older, younger, and full siblings and regardless of asthma diagnoses.
Conclusions:
Siblings have different dispensing patterns of asthma medications compared with singletons regardless of asthma diagnoses. After including the siblings' asthma medication and compared with control children, the proportion of children with persistent medication increased which may indicate that siblings share asthma medications.
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