Adherence to combined montelukast and fluticasone treatment in economically disadvantaged African American youth with asthma

Kelly A. McNally, Jennifer Rohan, Mark Schluchter, Kristin A. Riekert, Pamela Vavrek, Amy Schmidt, Susan Redline, Carolyn Kercsmar, Dennis Drotar

Research output: Contribution to journalArticle

Abstract

High rates of asthma treatment nonadherence have been reported, particularly in economically disadvantaged African American youth. The relationship between adherence to combined medication treatment and asthma outcomes has potential clinical significance but is not well understood. Using electronic monitoring, we describe the pattern of adherence to daily corticosteroid (fluticasone) and leukotriene receptor antagonist (montelukast) medication over the course of 1 year in a population of African American youth with moderate to severe asthma. On average, adherence to montelukast was higher than adherence to fluticasone (p < 0.01); however, for both medications, adherence rates significantly declined over the course of the study. After 1 year, participants took only 31 of prescribed doses of montelukast and 23 of prescribed doses of fluticasone. The decline in adherence to both fluticasone (p < 0.05) and montelukast (p < 0.001) was related to increased healthcare utilization. Furthermore, asthma symptom ratings were related montelukast (p < 0.001), but not fluticasone adherence. These results suggest that adherence promotion intervention strategies are warranted to improve health-related outcomes in families who are at-risk for treatment nonadherence.

Original languageEnglish (US)
Pages (from-to)921-927
Number of pages7
JournalJournal of Asthma
Volume46
Issue number9
DOIs
StatePublished - Nov 5 2009

    Fingerprint

Keywords

  • Compliance
  • Growth curve
  • Health care utilization
  • Pediatric asthma
  • Treatment adherence

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Immunology and Allergy
  • Pulmonary and Respiratory Medicine

Cite this

McNally, K. A., Rohan, J., Schluchter, M., Riekert, K. A., Vavrek, P., Schmidt, A., Redline, S., Kercsmar, C., & Drotar, D. (2009). Adherence to combined montelukast and fluticasone treatment in economically disadvantaged African American youth with asthma. Journal of Asthma, 46(9), 921-927. https://doi.org/10.3109/02770900903229651