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Use of inhaled anti-inflammatory medication in children with asthma in managed care settings

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dc.contributor.authorAdams, R.
dc.contributor.authorFuhlbrigge, A.
dc.contributor.authorFinkelstein, J.
dc.contributor.authorLozano, P.
dc.contributor.authorLivingston, J.
dc.contributor.authorWeiss, K.
dc.contributor.authorWeiss, S.
dc.date.issued2001
dc.description© 2001 American Medical Association. All rights reserved.
dc.description.abstractBACKGROUND: 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
dc.description.statementofresponsibilityRobert J. Adams, Anne Fuhlbrigge, Jonathan A. Finkelstein, Paula Lozano, James M. Livingston, Kevin B. Weiss and Scott T. Weiss
dc.identifier.citationJAMA Pediatrics, 2001; 155(4):501-507
dc.identifier.doi10.1001/archpedi.155.4.501
dc.identifier.issn1072-4710
dc.identifier.issn1538-3628
dc.identifier.orcidAdams, R. [0000-0002-7572-0796]
dc.identifier.urihttp://hdl.handle.net/2440/9810
dc.language.isoen
dc.publisherAmer Medical Assoc
dc.source.urihttp://archpedi.ama-assn.org/cgi/reprint/155/4/501.pdf
dc.subjectHumans
dc.subjectAsthma
dc.subjectSteroids
dc.subjectAnti-Inflammatory Agents
dc.subjectAnti-Asthmatic Agents
dc.subjectAdministration, Inhalation
dc.subjectSeverity of Illness Index
dc.subjectMultivariate Analysis
dc.subjectLogistic Models
dc.subjectCross-Sectional Studies
dc.subjectAge Distribution
dc.subjectSex Distribution
dc.subjectAdolescent
dc.subjectChild
dc.subjectChild, Preschool
dc.subjectManaged Care Programs
dc.subjectDrug Utilization
dc.subjectGuideline Adherence
dc.subjectUnited States
dc.subjectFemale
dc.subjectMale
dc.subjectPractice Guidelines as Topic
dc.subjectPractice Patterns, Physicians'
dc.titleUse of inhaled anti-inflammatory medication in children with asthma in managed care settings
dc.typeJournal article
pubs.publication-statusPublished

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