Patterns of quick-relief and long-term controller medication use in pediatric asthma.
OBJECTIVE
To simultaneously examine adherence to long-term controller and quick-relief medications and to contrast patterns of medication use in children with asthma.


METHODS
Cross-sectional, 1-month follow-up study conducted with 75 children ages 8 to 16 years diagnosed with persistent asthma and prescribed quick-relief and long-term controller medications by metered dose inhaler. Participants were a subsample of a larger adherence study. The primary outcome measure was adherence to both medications as measured by electronic monitoring devices. A classification framework for contrasting adherence patterns between medication classes was developed to identify cases for individual analysis.


RESULTS
High levels of nonadherence to long-term controller medications (median = 46% of prescribed doses taken) and variable patterns of quick-relief medication use (range = 0 to 251 doses over the month) were documented, whereas consistent relationships between patterns of medication use across both classes were not found. Individual cases identified by the classification scheme illustrated the complexity and clinical utility of contrasting adherence patterns.


CONCLUSIONS
Monitoring long-term controller medication adherence may be more predictive of morbidity than quick-relief medication use, except in outlier cases in which monitoring both medication types may be valuable for clinical and empirical purposes.
Walders
Natalie
N
National Jewish Medical and Research Center, Denver, Colorado 80206, USA.
Kopel
Sheryl J
SJ
Koinis-Mitchell
Daphne
D
McQuaid
Elizabeth L
EL
D000280:Administration, Inhalation; D000293:Adolescent; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004334:Drug Administration Schedule; D004582:Electronics, Medical / Q000295:instrumentation; D005260:Female; D006801:Humans; D007223:Infant; D016015:Logistic Models; D008297:Male; D010349:Patient Compliance / Q000706:statistics & numerical data; D013997:Time Factors; D016896:Treatment Outcome
D018927:Anti-Asthmatic Agents