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|Title:||Use of inhaled anti-inflammatory medication in children with asthma in managed care settings|
|Citation:||Archives of Pediatrics & Adolescent Medicine, 2001; 155(4):501-507|
|Publisher:||Amer Medical Assoc|
|Robert J. Adams, Anne Fuhlbrigge, Jonathan A. Finkelstein, Paula Lozano, James M. Livingston, Kevin B. Weiss and Scott T. Weiss|
|Abstract:||BACKGROUND: Many factors affect use of inhaled therapy in asthma. Relatively little is known about current patterns of use of anti-inflammatory medication in children with asthma and whether variations occur with age and use of bronchodilator medication. OBJECTIVE: To study the factors associated with dispensing of anti-inflammatory (controller) asthma medication to children in 3 managed care organizations (MCOs). METHODS: Using automated databases, a 1-year cross-sectional study of children with asthma aged 3 to 15 years cared for in 3 MCOs was used to evaluate the association of age and other factors with controller medication use. RESULTS: A total of 13 352 children were studied. Significantly fewer children aged 3 to 5 years were dispensed any (1) controller medication than older children (P<.001). Among children dispensed 6 or more ß-agonists, only 39% also received 5 or more controller dispensings, with adolescents significantly less likely than younger children to receive 5 or more controllers (33%; P<.001). Significant differences were seen among MCOs in proportions of patients dispensed controller medication. In a multiple logistic regression model, controlling for frequency of ß-agonist dispensing and MCO, significantly lower dispensing of any controller medication was seen for those aged 3 to 5 years (odds ratio [OR], 0.8; 95% confidence interval [CI], 0.7-0.9) and for girls (OR, 0.9; 95% CI, 0.8-0.96). In contrast, for repeated (5) controller dispensing there were significantly fewer dispensings to adolescents (OR, 0.7; 95% CI, 0.6-0.9) and girls (OR, 0.8; 95% CI, 0.7-0.9). CONCLUSIONS: There may be differences in the use of preventive asthma medication in children that are affected by age, sex, and health care organization. Few children with frequent symptoms are using controllers regularly, as is recommended by national guidelines|
|Keywords:||Humans; Asthma; Steroids; Anti-Inflammatory Agents; Anti-Asthmatic Agents; Administration, Inhalation; Severity of Illness Index; Multivariate Analysis; Logistic Models; Cross-Sectional Studies; Age Distribution; Sex Distribution; Adolescent; Child; Child, Preschool; Managed Care Programs; Drug Utilization; Physician's Practice Patterns; Guideline Adherence; United States; Female; Male; Practice Guidelines as Topic|
|Description:||© 2001 American Medical Association. All rights reserved.|
|Appears in Collections:||Medicine publications|
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