TY - JOUR
T1 - Factors associated with high short-acting β2-agonist use in urban children with asthma
AU - Butz, Arlene M.
AU - Ogborn, Jean
AU - Mudd, Shawna
AU - Ballreich, Jeromie
AU - Tsoukleris, Mona
AU - Kub, Joan
AU - Bellin, Melissa
AU - Bollinger, Mary Elizabeth
N1 - Publisher Copyright:
© 2015 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.
PY - 2015/5/1
Y1 - 2015/5/1
N2 - 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. Conclusion Providers should closely monitor SABA and controller medication use, allergen sensitization, and exposures in children with persistent asthma. Trial registration ClinicalTrials.gov, identifier NCT01981564.
AB - 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. Conclusion Providers should closely monitor SABA and controller medication use, allergen sensitization, and exposures in children with persistent asthma. Trial registration ClinicalTrials.gov, identifier NCT01981564.
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U2 - 10.1016/j.anai.2015.03.002
DO - 10.1016/j.anai.2015.03.002
M3 - Article
C2 - 25840499
AN - SCOPUS:84929512628
SN - 1081-1206
VL - 114
SP - 385
EP - 392
JO - Annals of Allergy, Asthma and Immunology
JF - Annals of Allergy, Asthma and Immunology
IS - 5
ER -