Identifying which children with persistent asthma have preventive medications available at home

Abstract

Objective: To compare caregiver-reported preventive medication use and pharmacy data with medications available at home for children with persistent asthma, and identify factors associated with having preventive medication at home.Methods: We analyzed baseline data from the School-Based Telemedicine Enhanced Asthma Management (SB-TEAM) study, including medication use, symptoms, and demographics. Research assistants documented all asthma medications available during home visits. We reviewed pharmacy records for a subset of children. Bivariate and multivariate analyses identified factors associated with having any preventive medication in the home.Results: We included 335 children (mean 7.7 years, 56% Black, 34% Hispanic, 77% Medicaid; participation 79%). Most caregivers (69%) reported preventive medication use, yet only 45% had preventive medication at home. Compared to families with preventive medication at home, more families without preventive medication reported discontinuous insurance in the prior year (7% vs. 15%, p = .02) and medication sharing (22% vs. 32%, p = .04). For the subset with pharmacy records (n = 192), 40% filled a preventive medication in the past year and 15% had a preventive medication at home. In multivariate analyses, children were less likely to have preventive medication at home when caregivers reported no preventive medication use in the past 2 weeks (OR 0.25; 95% CI 0.14, 0.43), discontinuous insurance (OR 0.42; 95% CI 0.19, 0.97), medication sharing (OR 0.54; 95% CI 0.32, 0.91), or caregiver education ≥ HS (OR 0.59; 95% CI 0.35, 0.99).Conclusion: Among urban children with persistent asthma, neither caregiver report nor pharmacy data reflect home preventive medication availability. Inquiring about insurance coverage and medication sharing may improve preventive medication availability for these children.