Enhancing medication adherence among inner-city children with asthma

Results from pilot studies

Susan J. Bartlett, Peter Lukk, Arlene Manns Butz, Francine Lampros-Klein, Cynthia S Rand

Research output: Contribution to journalArticle

Abstract

Despite the availability of effective treatments that aid in controlling asthma symptoms, inner-city children with asthma have high rates of morbidity and are frequent users of emergency department services. The goal of these studies was to pilot test an intervention that used social learning strategies (e.g., goal-setting, monitoring, feedback, reinforcement, and enhanced self-efficacy) and targeted known barriers to individualize a family-based asthma action plan. Participants were 15 children with asthma, aged 7-12 years, who had been prescribed at least one daily inhaled steroid. The children and their mothers lived in inner-city Baltimore and all were African-American. Participants received up to five visits in their home by a nurse. Electronic monitors were installed on the children's MDI to provide immediate feedback on medication adherence to the families and validate medication use. At baseline, only 28.6% of the children were using their medications as prescribed. Within four weeks, the number of children who were using their medications appropriately doubled from 28.6% at baseline to 54.1% (90% increase; p = 0.004), while underutilization decreased from 51.2% to 25.4% (100% decrease; p = 0.02). The number of children with no medication use at all dropped from 28.3% at baseline to 15.1% by week 5 (87% decrease; p = 0.009). Thus, within four weeks, more than half the children were using their inhaled steroids appropriately. In addition, the rate of underutilization decreased and that of nonutilization was cut in half. Our initial data suggest that an individualized, home-based intervention can signifcantly enhance adherence to the daily use of inhaled steroids in inner-city children with asthma. Nevertheless, adherence to daily inhaled steroid therapy remains a significant problem in this group.

Original languageEnglish (US)
Pages (from-to)47-54
Number of pages8
JournalJournal of Asthma
Volume39
Issue number1
DOIs
StatePublished - 2002

Fingerprint

Medication Adherence
Asthma
Steroids
Baltimore
Community Health Nurses
Self Efficacy
African Americans
Hospital Emergency Service
Mothers
Morbidity

Keywords

  • Child-parent relations
  • Childhood asthma
  • Inner-city children
  • Medication adherence
  • Self-efficacy

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Enhancing medication adherence among inner-city children with asthma : Results from pilot studies. / Bartlett, Susan J.; Lukk, Peter; Butz, Arlene Manns; Lampros-Klein, Francine; Rand, Cynthia S.

In: Journal of Asthma, Vol. 39, No. 1, 2002, p. 47-54.

Research output: Contribution to journalArticle

Bartlett, Susan J. ; Lukk, Peter ; Butz, Arlene Manns ; Lampros-Klein, Francine ; Rand, Cynthia S. / Enhancing medication adherence among inner-city children with asthma : Results from pilot studies. In: Journal of Asthma. 2002 ; Vol. 39, No. 1. pp. 47-54.
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