Patterns of quick-relief and long-term controller medication use in pediatric asthma

被引:75
作者
Walders, N
Kopel, SJ
Koinis-Mitchell, D
McQuaid, EL
机构
[1] Natl Jewish Med & Res Ctr, Denver, CO USA
[2] Brown Med Sch, Bradley Hasbro Res Ctr, Providence, RI USA
关键词
D O I
10.1016/j.jpeds.2004.10.014
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Objectives To simultaneously examine adherence to long-term controller and quick-relief medications and to contrast patterns of medication use in children with asthma. Study design Cross-sectional, 1-month follow-up study conducted with 75 children ages 8 to 16 years diagnosed with persistent asthma and prescribed quick-relief and long-term controller medications by metered dose inhaler. Participants were a subsample of a larger adherence study. The primary outcome measure was adherence to both medications as measured by electronic monitoring devices. A classification framework for contrasting adherence patterns between medication classes was developed to identify cases for individual analysis. Results High levels of nonadherence to long-term controller medications (median = 46% of prescribed doses taken) and variable patterns of quick-relief medication use (range = 0 to 251 doses over the month) were documented, whereas consistent relationships between patterns of medication use across both classes were not found. Individual cases identified by the classification scheme illustrated the complexity and clinical utility of contrasting adherence patterns. Conclusions Monitoring long-term controller medication adherence may be more predictive of morbidity than quick-relief medication use, except in outlier cases in which monitoring both medication types may be valuable for clinical and empirical purposes.
引用
收藏
页码:177 / 182
页数:6
相关论文
共 34 条
[1]   Use of inhaled anti-inflammatory medication in children with asthma in managed care settings [J].
Adams, RJ ;
Fuhlbrigge, A ;
Finkelstein, JA ;
Lozano, P ;
Livingston, JM ;
Weiss, KB ;
Weiss, ST .
ARCHIVES OF PEDIATRICS & ADOLESCENT MEDICINE, 2001, 155 (04) :501-507
[2]   Adherence with twice-daily dosing of inhaled steroids - Socioeconomic and health-belief differences [J].
Apter, AJ ;
Reisine, ST ;
Affleck, G ;
Barrows, E ;
ZuWallack, RL .
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 1998, 157 (06) :1810-1817
[3]   Enhancing medication adherence among inner-city children with asthma: Results from pilot studies [J].
Bartlett, SJ ;
Lukk, P ;
Butz, A ;
Lampros-Klein, F ;
Rand, CS .
JOURNAL OF ASTHMA, 2002, 39 (01) :47-54
[4]   Relationship of adherence to pediatric asthma morbidity among inner-city children [J].
Bauman, LJ ;
Wright, E ;
Leickly, FE ;
Carin, E ;
Kurszon-Moran, D ;
Wade, SL ;
Visness, CM .
PEDIATRICS, 2002, 110 (01) :e6
[5]   Psychological factors associated with medication nonadherence in asthmatic children [J].
Bender, B ;
Milgrom, H ;
Rand, C ;
Ackerson, L .
JOURNAL OF ASTHMA, 1998, 35 (04) :347-353
[6]   Measurement of children's asthma medication adherence by self report, mother report, canister weight, and Doser CT [J].
Bender, B ;
Wamboldt, FS ;
O'Connor, SL ;
Rand, C ;
Szefler, S ;
Milgrom, H ;
Wamboldt, MZ .
ANNALS OF ALLERGY ASTHMA & IMMUNOLOGY, 2000, 85 (05) :416-421
[7]   Relationship between disease and psychological adaptation in children in the childhood asthma management program and their families [J].
Bender, BG ;
Annett, RD ;
Iklé, D ;
DuHamel, TR ;
Rand, C ;
Strunk, RC .
ARCHIVES OF PEDIATRICS & ADOLESCENT MEDICINE, 2000, 154 (07) :706-713
[8]   Nebulizer use in inner-city children with asthma -: Morbidity, medication use, and asthma management practices [J].
Butz, AM ;
Eggleston, P ;
Huss, K ;
Kolodner, K ;
Rand, C .
ARCHIVES OF PEDIATRICS & ADOLESCENT MEDICINE, 2000, 154 (10) :984-990
[9]   Treatment adherence among low-income children with asthma [J].
Celano, M ;
Geller, RJ ;
Phillips, KM ;
Ziman, R .
JOURNAL OF PEDIATRIC PSYCHOLOGY, 1998, 23 (06) :345-349
[10]  
Centers for Disease Control and Prevention (CDC), 1996, MMWR Morb Mortal Wkly Rep, V45, P350