title: Adherence to pediatric asthma treatment in economically disadvantaged African-American children and adolescents: an application of growth curve analysis.
abstract: OBJECTIVE
  The primary aims of the study were to: (a) describe the trajectories of adherence to daily inhaled corticosteroid (ICS) medication for a year in economically disadvantaged, African-American youth with asthma based on growth curve modeling; and (b) test the relationship of treatment adherence to symptom control, quick-relief medication, and healthcare utilization.
  
  
  METHODS
  This prospective study measured adherence to daily ICS treatment using electronic monitoring in 92 children and adolescents with moderate to severe asthma for 9-12 months and assessed clinical outcomes, including asthma-related symptoms, quick-relief medication, and healthcare utilization.
  
  
  RESULTS
  Youth showed a decrement in treatment adherence to less than half of prescribed corticosteroid treatment over the course of the study, which related to increased healthcare utilization (p < .04), but not to asthma symptoms or albuterol use.
  
  
  CONCLUSIONS
  Economically disadvantaged youth with asthma demonstrate high rates of chronic nonadherence that warrant identification and intervention to reduce asthma-related healthcare utilization.
authors.affiliation: Department of Pediatrics, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave MLC 7039, Cincinnati, OH 45229, USA. jennifer.rohan@cchmc.org
authors.forename: Jennifer
authors.initials: J
authors.lastname: Rohan
authors.forename: Dennis
authors.initials: D
authors.lastname: Drotar
authors.forename: Kelly
authors.initials: K
authors.lastname: McNally
authors.forename: Mark
authors.initials: M
authors.lastname: Schluchter
authors.forename: Kristin
authors.initials: K
authors.lastname: Riekert
authors.forename: Pamela
authors.initials: P
authors.lastname: Vavrek
authors.forename: Amy
authors.initials: A
authors.lastname: Schmidt
authors.forename: Susan
authors.initials: S
authors.lastname: Redline
authors.forename: Carolyn
authors.initials: C
authors.lastname: Kercsmar
mesh_terms: D000280:Administration, Inhalation; D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000191:economics* / Q000627:therapeutic use*; D000318:Adrenergic beta-Agonists / Q000008:administration & dosage; D001741:Black or African American / Q000706:statistics & numerical data*; D000420:Albuterol / Q000008:administration & dosage; D001249:Asthma / Q000188:drug therapy* / Q000191:economics; D002648:Child; D003695:Delivery of Health Care / Q000191:economics / Q000706:statistics & numerical data*; D004334:Drug Administration Schedule; D005260:Female; D057238:Growth Charts; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014481:United States; D016903:Drug Monitoring
chemical_list: D000305:Adrenal Cortex Hormones; D000318:Adrenergic beta-Agonists; D000420:Albuterol