title: Medication use patterns among urban youth participating in school-based asthma education.
abstract: Although pharmaceutical management is an integral part of asthma control, few community-based analyses have focused on this aspect of disease management. The primary goal of this analysis was to assess whether participation in the school-based Kickin' Asthma program improved appropriate asthma medication use among middle school students. A secondary goal was to determine whether improvements in medication use were associated with subsequent improvements in asthma-related symptoms among participating students. Students completed an in-class case-identification questionnaire to determine asthma status. Eligible students were invited to enroll in a school-based asthma curriculum delivered over four sessions by an asthma health educator. Students completed a pre-survey and a 3-month follow-up post-survey that compared symptom frequency and medication use. From 2004 to 2007, 579 participating students completed pre- and post-surveys. Program participation resulted in improvements in appropriate use across all three medication use categories: 20.0% of students initiated appropriate reliever use when "feeling symptoms" (p < 0.001), 41.6% of students reporting inappropriate medication use "before exercise" initiated reliever use (p < 0.001), and 26.5% of students reporting inappropriate medication use when "feeling fine" initiated controller use (p < 0.02). More than half (61.6%) of participants reported fewer symptoms at post-survey. Symptom reduction was not positively associated with improvements in medication use in unadjusted and adjusted analysis, controlling for sex, asthma symptom classification, class attendance, season, and length of follow-up. Participation in a school-based asthma education program significantly improved reliever medication use for symptom relief and prior-to-exercise and controller medication use for maintenance. However, given that symptom reduction was not positively associated with improvement in medication use, pharmaceutical education must be just one part of a comprehensive asthma management agenda that addresses the multifactorial nature of asthma-related morbidity.
authors.affiliation: Division of Epidemiology, School of Public Health, University of California, Berkeley, CA, USA. bina513@gmail.com
authors.forename: Bina
authors.initials: B
authors.lastname: Patel Shrimali
authors.forename: Amira
authors.initials: A
authors.lastname: Hasenbush
authors.forename: Adam
authors.initials: A
authors.lastname: Davis
authors.forename: Ira
authors.initials: I
authors.lastname: Tager
authors.forename: Sheryl
authors.initials: S
authors.lastname: Magzamen
mesh_terms: D000293:Adolescent; D018927:Anti-Asthmatic Agents / Q000592:standards / Q000627:therapeutic use; D001249:Asthma / Q000188:drug therapy*; D002140:California; D002648:Child; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D010353:Patient Education as Topic; D015397:Program Evaluation; D012572:School Health Services; D012648:Self Care; D014504:Urban Health; D016903:Drug Monitoring
chemical_list: D018927:Anti-Asthmatic Agents