title: Factors associated with high short-acting β2-agonist use in urban children with asthma.
abstract: BACKGROUND
  One goal of guideline-based asthma therapy is minimal use of short-acting β₂ agonist (SABA) medications. Inner-city children with asthma are known to have high SABA use.
  
  
  OBJECTIVE
  To examine factors associated with high SABA use in inner-city children with asthma.
  
  
  METHODS
  One hundred inner-city children with persistent asthma were enrolled into a randomized controlled trial of an emergency department (ED) and home intervention. All children underwent serologic allergen specific IgE and salivary cotinine testing at the ED enrollment visit. Pharmacy records for the past 12 months were obtained. Number of SABA fills during the past 12 months was categorized into low- to moderate- vs high-use groups. SABA groups were compared by the number of symptom days and nights, allergen sensitization, and exposures. Regression models were used to predict high SABA use.
  
  
  RESULTS
  Mean number of SABA fills over 12 months was 3.12. Unadjusted bivariate analysis showed that high SABA users were more than 5 times more likely to have an asthma hospitalization, almost 3 times more likely to have an asthma intensive care unit admission, and more than 3 times more likely to have prior specialty asthma care or positive cockroach sensitization than low to moderate SABA users. In the final regression model, for every additional inhaled corticosteroid fill, a child was 1.4 times more likely and a child with positive cockroach sensitization was almost 7 times more likely to have high SABA use when controlling for prior intensive care unit admission, receipt of specialty care, child age, and income.
  
  
  CONCLUSIONS
  Providers should closely monitor SABA and controller medication use, allergen sensitization, and exposures in children with persistent asthma.
  
  
  BACKGROUND
  ClinicalTrials.gov, identifier NCT01981564.
authors.affiliation: Department of Pediatrics, The Johns Hopkins University School of Medicine, Baltimore, Maryland. Electronic address: abutz@jhmi.edu.
authors.forename: Arlene M
authors.initials: AM
authors.lastname: Butz
authors.affiliation: Department of Pediatric Emergency Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors.forename: Jean
authors.initials: J
authors.lastname: Ogborn
authors.affiliation: The Johns Hopkins University School of Nursing, Baltimore, Maryland.
authors.forename: Shawna
authors.initials: S
authors.lastname: Mudd
authors.affiliation: The Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland.
authors.forename: Jeromie
authors.initials: J
authors.lastname: Ballreich
authors.affiliation: The University of Maryland School of Pharmacy, Baltimore, Maryland.
authors.forename: Mona
authors.initials: M
authors.lastname: Tsoukleris
authors.affiliation: The Johns Hopkins University School of Nursing, Baltimore, Maryland.
authors.forename: Joan
authors.initials: J
authors.lastname: Kub
authors.affiliation: The University of Maryland School of Social Work, Baltimore, Maryland.
authors.forename: Melissa
authors.initials: M
authors.lastname: Bellin
authors.affiliation: Department of Pediatrics, The University of Maryland School of Medicine, Baltimore, Maryland.
authors.forename: Mary Elizabeth
authors.initials: ME
authors.lastname: Bollinger
mesh_terms: D058666:Adrenergic beta-2 Receptor Agonists / Q000627:therapeutic use*; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy* / Q000276:immunology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D014505:Urban Population
chemical_list: D058666:Adrenergic beta-2 Receptor Agonists; D018927:Anti-Asthmatic Agents
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