Reviews and feature articleNegative affect, medication adherence, and asthma control in children
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One hundred four participants were recruited through advertising and referrals from multiple practices and clinics in the Denver area and met the following inclusion criteria: age 8 to 18 years with a current diagnosis of asthma by a health care provider who prescribed an inhaled corticosteroid (ICS) delivered by metered-dose inhaler (MDI), otherwise in good general health including no significant learning or psychological problems that might interfere with study participation. One parent from
Demographic and adherence profile of participants
Age, sex, race, and smoking household frequencies and their associated medication adherence levels are seen in Table I. Mean adherence rates did not differ significantly by age, sex, or race, although trends suggested that white and other participants were more adherent than black or Hispanic participants. Mean adherence was significantly lower for children in households with a smoking adult in contrast with nonsmoking households. The average rate of adherence across all participants was 40%
Discussion
On average, participants in this study used less than 40% of their prescribed ICS. Although this finding is consistent with other studies using an objective measure of adherence in pediatric patients with asthma,41, 42, 43, 44, 45, 46, 47, 48 most studies of adherence in children with asthma have not tested whether adherence predicts control, and none have directly tested whether an association between affect and control exists and is explained by level of adherence. Recognizing both that
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Supported by General Clinical Research Centers grant M01-RR00051 and National Heart, Lung, and Blood Institute grant 5R01HL64199.
Disclosure of potential conflict of interest: B. Bender has received research support from the National Heart, Lung, and Blood Institute, AstraZeneca, and Sepracor. L. Zhang has declared that she has no conflict of interest.