Self-Administration of Asthma Medication in Children and Asthma Control

Abstract

RATIONALE: In the pediatric asthmatic population, the impact of place of residence and who administers asthma medication on asthma compliance and control is unclear. However, some may assume that inner city children who self-administer asthma medication would fare poorly in comparison with suburban patients whose parents administer medication. METHODS: Parent and patient questionnaires were completed for 31 children (ages 4 to 18 years old) with moderate- to severe-persistent asthma. Suburban asthmatic patients were managed by pediatricians. Inner city asthmatic patients were managed in our allergy clinic. Medication compliance was determined based upon reported number of missed doses. Asthma control was based upon night symptoms, rescue inhaler use, interference with activity, oral steroid use, ED visits, and hospital admissions. RESULTS: Comparison of suburban asthmatics managed by pediatricians and inner city asthmatics managed by allergists yielded no significant differences in medication compliance or asthma control. There was also no significant difference in these parameters when comparing parent medication administration with patient medication self-administration in either the suburban or inner city subjects. CONCLUSIONS: Effective asthma control is attainable in inner city children with moderate to severe asthma; and the medication administrator does not impact this control.