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Responsibility for Asthma Management Among Adolescents With and Without Attention-Deficit/Hyperactivity Disorder
Andrea Milne Wenderlich1, Constance D Baldwin1, Maria Fagnano1
1Department of Pediatrics, University of Rochester School of Medicine, Rochester, New York.
Adolescents with attention-deficit/hyperactivity disorder (ADHD) and asthma have higher healthcare use and less self-management responsibility. This highlights a need for targeted support to improve asthma care for these teens.
Area of Science:
- Pediatric Pulmonology
- Child and Adolescent Psychiatry
- Health Services Research
Background:
- Persistent asthma is a significant health concern for urban adolescents.
- Attention-deficit/hyperactivity disorder (ADHD) is a common comorbidity that may impact asthma management.
- Understanding the interplay between ADHD and asthma is crucial for effective clinical care.
Purpose of the Study:
- To investigate the association between ADHD comorbidity and clinical outcomes in low-income urban adolescents with persistent asthma.
- To compare healthcare utilization in adolescents with asthma alone versus those with comorbid ADHD.
- To examine the impact of ADHD on shared responsibility for asthma self-management between adolescents and caregivers.
Main Methods:
- Secondary analysis of a school-based study involving 370 diverse, low-income urban adolescents with persistent asthma.
- Data collection included self-reported asthma symptoms over two weeks and healthcare utilization (primary care, hospitalizations) over one year.
- Assessment of shared responsibility for nine asthma management tasks between adolescents and their caregivers.
Main Results:
- Attention-deficit/hyperactivity disorder (ADHD) comorbidity was prevalent, affecting 28% of the study sample.
- Adolescents with ADHD exhibited significantly higher primary care utilization and hospital admission rates compared to peers without ADHD, despite similar asthma symptom severity.
- Caregivers and adolescents with ADHD reported reduced shared responsibility for asthma self-management tasks.
Conclusions:
- Adolescents with ADHD demonstrate a lower level of engagement in asthma self-management.
- The increased healthcare utilization among adolescents with ADHD presents a critical opportunity for healthcare providers to implement enhanced self-management support strategies.
- Targeted interventions addressing both ADHD and asthma management are needed for this vulnerable population.
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