Responsibility
for Asthma?Who?s Taking Care?
Linda Radecki, MS 1,
Kevin B. Weiss, MD, MPH 2, and L ynn M. Olson, PhD
1. 1 Practice and Research, American Academy
of Pediatrics, Elk Grove Village, IL, United States, 60007 and 2 Center for Healthcare Studies, Northwestern
University & Hines VA Hospital, Chicago, IL, United States,
60611. Poster presentation to the American Academy of Allergy, Asthma,
and Immunology, 2005.
Background:
Responsibility for care away from the physician?s office is
an important clinical issue in pediatric asthma management. Who
takes the onus for management - parent or child? How do these issues
relate to medication compliance?
Methods:
Children & parents completed a questionnaire on asthma responsibility
as part of a larger study to examine children?s ability to report
on their own health status.
Results:
60% of the sample were males;child age M=10.8 years; 49% African
American. Mean sx days in the previous 2
weeks reported by parent and child were 3.2 and 2.7 days, respectively.Asked
how often the child takes medications on his/her own, 65% of parents
reported "all or pretty much" of the time; child report
was slightly higher (69%). Parent-child agreement on child's responsibility
for medication use was 65%. Based on parent report, nearly 1/3 of
children took medications as prescribed only "some to none"
of the time. Among parents who reported poor compliance, over 50%
reported that the child took meds by sel "most" or "all"
of the time (X2=7.6, p<.01). Parent account of child responsibility
for self-medication increased with child age - 51% of 7-9 year olds
had primary responsibility while 75% of 14-16 year olds had similar
responsibility.
Conclusions:
In this study, a majority of youth reportedly had primary responsibility
for taking their asthma medications with less
than optimal compliance. These findings emphasize the need to understand
what happens when families leave the office setting and to provide
developmentally appropriate education regarding why and how asthma
medications should be taken.
