title: Better breathing or better living? A qualitative analysis of the impact of asthma medication acquisition on standard of living and quality of life in low-income families of children with asthma.
abstract: BACKGROUND
  Purchasing children's asthma medications places a burden on low-income families. The objective of this study was to explore how purchasing children's asthma medications influenced household purchasing behavior and quality of life in low-income families with no drug insurance.
  
  
  METHODS
  Seventeen parents residing in the Greater Toronto Area with no drug plan and with household incomes below 45,000 US dollars (twice the U.S. poverty level) participated. Semi-structured interviews were conducted, emphasizing the topics of prescription drugs used and cost versus effectiveness; purchasing behavior and drug administration; effects of medication purchasing on the family; and payment assistance. Transcribed narratives were coded and analyzed thematically.
  
  
  RESULTS
  Annual expenditures for asthma drugs were 300 US dollars to 3000 US dollars. Because asthma management was a high priority, foregone expenditures included paying for other family members' health needs, essentials (clothing, food, better housing), and nonessentials (recreation, vacations) and long-term investments, such as their child's future education and their retirement. Respondents believed quality of life was negatively affected.
  
  
  CONCLUSIONS
  Not addressing the health concerns of family members, making sacrifices, and modifying investment decisions created sustained anxiety in families of children with asthma. Access to medication benefits would have a positive impact on quality of life. Health care providers can help to ensure that low-income families receive available assistance.
authors.affiliation: The Hospital for Sick Children, Toronto, Canada. wendy.ungar@sickkids.ca
authors.forename: Wendy J
authors.initials: WJ
authors.lastname: Ungar
authors.forename: Tony
authors.initials: T
authors.lastname: Macdonald
authors.forename: Martha
authors.initials: M
authors.lastname: Cousins
mesh_terms: D000293:Adolescent; D018927:Anti-Asthmatic Agents / Q000191:economics / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy / Q000191:economics / Q000523:psychology; D002648:Child; D002675:Child, Preschool; D016527:Drug Costs; D005260:Female; D006801:Humans; D008297:Male; D009722:Nurse Practitioners; D011203:Poverty; D011788:Quality of Life
chemical_list: D018927:Anti-Asthmatic Agents