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Reduced asthma morbidity during COVID-19 in minority children: is medication adherence a reason?

Jonathan M Feldman1,2, Denise Serebrisky3, Sheena Starr1

  • 1Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA.

The Journal of Asthma : Official Journal of the Association for the Care of Asthma
|March 28, 2022
PubMed

Insights

Asthma control improved in minority children during COVID-19, despite decreased controller medication adherence. This suggests improved asthma outcomes were not linked to better adherence during the pandemic.

Area of Science:

  • Pediatric pulmonology
  • Epidemiology
  • Public health

Background:

  • The COVID-19 pandemic impacted various aspects of children's health, including chronic conditions like asthma.
  • Understanding changes in asthma control, medication adherence, and quality of life during the pandemic is crucial for vulnerable populations.

Purpose of the Study:

  • To examine objectively measured medication adherence, asthma morbidity, and quality of life (QoL) in Black and Latinx children during the COVID-19 pandemic.
  • To compare pre-COVID (2019) and early-pandemic (2020) outcomes, including controller medication adherence, steroid bursts, healthcare utilization, and asthma control.

Main Methods:

  • Secondary analysis of 94 children (ages 10-17) with asthma from a longitudinal randomized controlled trial (RCT) comparison group.
  • Data collected from January-June 2019 (pre-COVID) and January-June 2020 (early pandemic).
  • Outcomes assessed included electronic adherence, oral steroid bursts, acute healthcare visits, caregiver QoL, and Asthma Control Test scores.

Main Results:

  • Controller medication adherence significantly decreased by 48% from 2019 to 2020 (33.9% vs. 17.6%).
  • A significant reduction in oral steroid bursts (1.29 vs. 0.61) and improved caregiver QoL scores were observed in 2020.
  • Asthma control significantly improved in 2020 (OR = 1.47), particularly from May-June, despite decreased medication adherence.

Conclusions:

  • Asthma morbidity decreased in minority children during the early COVID-19 pandemic.
  • This reduction in morbidity was not explained by improved adherence to controller medications.
  • Findings highlight a complex relationship between adherence, morbidity, and QoL during the pandemic.
Abstract

Keywords:
Complianceasthma controldisparitieshealthcare utilizationquality of life

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