Inadequate use of asthma medication in the United States: results of the asthma in America national population survey.
BACKGROUND
Studies of the use of anti-inflammatory asthma therapy have been limited to selected populations or have been unable to assess the appropriateness of therapy for individuals.


OBJECTIVE
We sought to describe the current use of asthma medication in the United States population and to examine the influence of symptoms and sociodemographics on medication use.


METHODS
This study was based on a cross-sectional, national, random-digit-dial household telephone survey in 1998 designed to identify adult patients and parents of children with current asthma. Respondents were classified as having current asthma if they had a physician's diagnosis of asthma and were either taking medication for asthma or had asthma symptoms during the past year.


RESULTS
One or more persons met the study criteria for current asthma in 3273 (7.8%) households in which a screening questionnaire was completed. Of these, 2509 persons (721 children <16 years) with current asthma were interviewed. Current use of anti-inflammatory medication was reported by 507 (20.1%). Of these, most were using inhaled corticosteroids (72.5%), with use of antileukotrienes reported by 11.4% and use of cromolyn-nedocromil reported by 18.6%. Of persons with persistent asthma symptoms in the past month, 26.2% reported current use of some form of anti-inflammatory medication. In bivariate analysis persons reporting lower income, less education, and present unemployment, as well as smokers, were significantly (P <.001) less likely to report current anti-inflammatory use than were other populations. In a multiple regression model nonsmokers and those of white, non-Hispanic ethnicity, as well as persons reporting less asthma control, were more likely to report current anti-inflammatory medication use.


CONCLUSIONS
In the United States use of appropriate asthma therapy remains inadequate. Strategies to increase use of anti-inflammatory therapy among patients with asthma are needed. These might include methods to increase access to asthma care for minorities and the socioeconomically disadvantaged.
Department of Medicine, University of Adelaide, The Queen Elizabeth Hospital Campus, Woodville, Australia.
Robert J
RJ
Adams
Anne
A
Fuhlbrigge
Theresa
T
Guilbert
Paula
P
Lozano
Fernando
F
Martinez
D000293:Adolescent; D000328:Adult; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy*; D002648:Child; D002675:Child, Preschool; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D012650:Self Disclosure; D012720:Severity of Illness Index; D012923:Social Class; D011795:Surveys and Questionnaires; D014481:United States
D018927:Anti-Asthmatic Agents