Adherence to pediatric asthma treatment in economically disadvantaged African-American children and adolescents: an application of growth curve analysis.
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.
Rohan
Jennifer
J
Department of Pediatrics, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave MLC 7039, Cincinnati, OH 45229, USA. jennifer.rohan@cchmc.org
Drotar
Dennis
D
McNally
Kelly
K
Schluchter
Mark
M
Riekert
Kristin
K
Vavrek
Pamela
P
Schmidt
Amy
A
Redline
Susan
S
Kercsmar
Carolyn
C
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
D000305:Adrenal Cortex Hormones; D000318:Adrenergic beta-Agonists; D000420:Albuterol