title: Factors associated with medication self-administration in children with asthma.
abstract: This study investigated factors associated with early self-administration of inhaled asthma medications by minority children. Specifically, the study evaluated: (1) the reasons parents allow early administration of inhaled medications, (2) childhood activities associated with early medication administration, (3) parent's perception of the child's ability to use a metered-dose inhaler (MDI), (4) the child's actual ability to use an MDI, and (5) concordance/discordance between physician-parent reports and parent-child reports of asthma medications. Study results indicated that 93% of the children were taking inhaled asthma medications without adult supervision. Early self-administration of asthma medications was related to the parent's employment status and the performance of other childhood behaviors such as completion of homework independently and crossing the street alone. Only 7% of the children had effective MDI skills, but 60% of the parents rated their child's MDI skills as excellent. Twenty percent, 67%, and 50%, respectively, of the parents' reports of beta-agonists, daily inhaled steroids, and cromolyn were discordant with the physician's actual prescriptions. Sixty-two percent, 57%, and 79%, respectively, of the children's reports for inhaled beta-agonists, daily inhaled steroids, and cromolyn were discordant with their parents' reports. Implications for anticipatory guidance, future educational strategies, and supervision of MDI technique are provided.
authors.affiliation: Johns Hopkins University School of Nursing, Baltimore, MD 21205, USA.
authors.forename: M L
authors.initials: ML
authors.lastname: Winkelstein
authors.forename: K
authors.initials: K
authors.lastname: Huss
authors.forename: A
authors.initials: A
authors.lastname: Butz
authors.forename: P
authors.initials: P
authors.lastname: Eggleston
authors.forename: P
authors.initials: P
authors.lastname: Vargas
authors.forename: C
authors.initials: C
authors.lastname: Rand
mesh_terms: D000293:Adolescent; D000318:Adrenergic beta-Agonists / Q000008:administration & dosage; D000328:Adult; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage*; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage; D001249:Asthma / Q000188:drug therapy*; D002648:Child; D004205:Cromolyn Sodium / Q000008:administration & dosage; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D009330:Nebulizers and Vaporizers; D010290:Parents; D012646:Self Administration / Q000706:statistics & numerical data; D013256:Steroids; D011795:Surveys and Questionnaires
chemical_list: D000318:Adrenergic beta-Agonists; D018927:Anti-Asthmatic Agents; D000893:Anti-Inflammatory Agents; D013256:Steroids; D004205:Cromolyn Sodium