At what age do children start taking daily asthma medicines on their own?
OBJECTIVE
Use of daily controller medications is a critical task in management of persistent asthma. Study aims were to examine (1) the association between child age and extent of daily controller-medication responsibility in a sample aged 4 to 19 years, (2) parent, child, and disease predictors of child daily controller-medication responsibility and overall daily controller-medication adherence, and (3) the association between child daily controller-medication responsibility and overall daily controller-medication adherence.


METHODS
We conducted a cross-sectional telephone survey of 351 parents of children who were prescribed daily controller medication. Children's mean age was 10.4 years; 61.5% were male, and 88.1% were white. Parents provided all data, including an estimate of the percentage of child and parent daily controller-medication responsibility. Daily controller-medication adherence was measured as parents' report of percentage of daily doses taken per doses prescribed in a typical week. We used multivariate linear regression to determine associations between parent race/ethnicity, education, income, number of dependents, child age, gender, years since diagnosis, parent perception of symptom severity and control, and dependent variables (child daily controller-medication responsibility and daily controller-medication adherence). We also examined associations between child daily controller-medication responsibility and daily controller-medication adherence.


RESULTS
Child daily controller-medication responsibility increased with age. By age 7, children had assumed, on average, almost 20% of daily controller-medication responsibility; by age 11, approximately 50%; by age 15, 75%; and by age 19, 100%. In multivariate models, child age and male gender remained significantly associated with child daily controller-medication responsibility, and child's age and parents' race/ethnicity remained significantly associated with daily controller-medication adherence.


CONCLUSIONS
Clinicians may need to screen for child daily controller-medication management and include even young children when educating families on the use of asthma medications and other key asthma-management tasks.
Orrell-Valente
Joan K
JK
Department of Pediatrics, Philip Lee Institute of Health Policy Studies, University of California, Division of Adolescent Medicine, 3333 California St, LH 245, Box 0503, San Francisco, CA 94143-0503, USA. joan.valente@ucsf.edu
Jarlsberg
Leah G
LG
Hill
Laura G
LG
Cabana
Michael D
MD
D000293:Adolescent; D000367:Age Factors; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage*; D001249:Asthma / Q000175:diagnosis / Q000188:drug therapy*; D002140:California; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010349:Patient Compliance / Q000706:statistics & numerical data*; D011237:Predictive Value of Tests; D011336:Probability; D012307:Risk Factors; D012646:Self Administration / Q000592:standards / Q000639:trends; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D055815:Young Adult; D016903:Drug Monitoring
D018927:Anti-Asthmatic Agents