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Treatment adherence among low-income children with asthma
M Celano1, R J Geller, K M Phillips
1Emory University School of Medicine, USA. mcelano@emory.edu
Insights
Asthma medication adherence was low in urban children, with poor inhaler technique and missed appointments. Improving adherence requires better clinical assessment and interventions for these children.
Area of Science:
- Pediatric Pulmonology
- Public Health
- Health Disparities
Background:
- Asthma affects many urban children, particularly minority populations.
- Adherence to asthma medication is crucial for disease management.
- Low-income, urban settings present unique challenges to adherence.
Purpose of the Study:
- To assess adherence behaviors in low-income, urban, primarily African American children with asthma.
- To identify specific areas of non-adherence, including medication use, technique, and appointments.
- To inform clinical strategies for improving asthma care in vulnerable populations.
Main Methods:
- Study included 55 children (ages 6-17) with moderate to severe asthma.
- Adherence to metered-dose inhaler (MDI) anti-inflammatory agents was measured by canister weight.
- Data collected on MDI/spacer technique, appointment attendance, and household smoking.
Main Results:
- Mean MDI medication use was only 44% of prescribed doses.
- 27% of participants exhibited MDI/spacer technique that hindered drug delivery.
- Nearly 50% reported household smoking; 21% missed appointments.
Conclusions:
- Significant adherence challenges exist for urban, low-income children with asthma.
- Poor MDI technique and missed appointments are key issues.
- Clinicians need improved methods to assess and enhance adherence in this population.
Objective:
To investigate the adherence behaviors (MDI use, MDI/spacer technique, appointment attendance, smoking in the home) of low-income, urban, primarily African American children with asthma.
Method:
Participants were 55 children ages 6 to 17 with moderate to severe asthma. Adherence to MDI anti-inflammatory agents was estimated primarily from canister weight at the follow-up appointment.
Results:
The mean use of MDI medication was 44% of prescribed use, with 27% of subjects demonstrating MDI/spacer technique likely to prevent drug delivery. Almost half reported that household members smoked cigarettes, and 21% missed scheduled follow-up appointments.
Conclusions:
These findings have implications for how clinicians should assess and improve adherence.