Lynn M. Olson, PhD 1,
Linda Radecki, MS 1
and Kevin B. Weiss, MD, MPH 2.
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,
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?
To assess parent and child report of asthma management and medication
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.
409 parent-child dyads completed questionnaires. 59% of the
children were male; child age M=10.9 years; 47% African American;
12% identified as Hispanic/Latino. Mean sx days in the previous
2 weeks reported by parent and child was 3.2 and 3.0 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
of self-responsibility for medication use was 68%. Parent-child
agreement on responsibility for medication use was 68%. Based on
parent report, over 1/4 (28%) of children took their medications
as prescribed only "some to none" of the time. Among parents who
reported poor compliance, over 50% also reported that the child
took meds by self "pretty much" to "all" of the time (X2=15.1, p<.01).
Parent account of child responsibility for medication increased
with child age - 50% of 7-9 year olds had primary responsibility
while 78% of 14-16 year olds had a similar level of responsibility
for own medication use. No differences in compliance or child responsibility
for medication were found by family income, education, marital status,
or own asthma status.
A majority of families report it is the child who has primary
responsibility for taking asthma medications. These findings suggest
a critical need to consider what happens when children leave the
office setting and to provide developmentally appropriate education
regarding why, how and when asthma medications should be taken.