More Children Using Preventive Asthma Drugs: Study
Minorities and uninsured had lower use of these medications, researchers say
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Monday, December 5, 2011
That number is up from about 18 percent of kids during the late 1980s.
Preventive asthma medications help control the airway disease before symptoms flare up, and guidelines from the U.S. National Asthma Education and Prevention Program recommend their use.
"The main finding from our study was that over 20 years, the use of medicines to prevent asthma has increased among children with asthma," said the study's lead author, Dr. Brian Kit, a medical epidemiologist at the U.S. Centers for Disease Control and Prevention's National Center for Health Statistics.
Commenting on the study, Dr. Shean Aujla, a pediatric pulmonologist at the Children's Hospital of Pittsburgh, said, "I think it's encouraging that there's been an increase in the use of preventive medications, but it's still only about one-third of kids with asthma using these drugs. I still think there's underdiagnosis and undertreatment of asthma."
Results of the study were released online Dec. 5, and will be published in the January 2012 issue of Pediatrics.
Preventive medications for asthma include inhaled corticosteroids, such as Pulmicort (budesonide) and Flovent (fluticasone); leukotriene-receptor antagonists, such as Singulair and Accolate; long-acting beta agonists, such as Serevent and Foradil; mast-cell stabilizers, such as Intal; and methylxanthines, such as Theo-Dur, according to the study.
Not everyone with asthma needs to take a daily preventive medication, Aujla noted. For example, youngsters with exercise-induced asthma often don't need to take a medication every day, just when they might have symptoms. But, many children with asthma can benefit from daily preventive medications, she said.
For the study, Kit and his colleagues used data from the U.S. National Health and Nutrition Examination Survey. They used information collected during three time periods: 1988 to 1994, 1999 to 2002 and 2005 to 2008.
The survey included data from nearly 2,500 children from across the United States, who were between the ages of 1 and 19 years. All of these children reported having asthma currently.
During 1988 to 1994, about 18 percent of children and teens with asthma used a preventive medication. By 1999 to 2002, that number had risen to 21 percent, and by 2005 to 2008, nearly 35 percent of children and teens were using a preventive asthma medication.
The researchers found that preteens and teenagers had the lowest use of preventive medications. In 2005 to 2008, about 43 percent of kids between the ages of 1 and 5 years old used preventive drugs. In kids from 6 to 11 years old, about 45 percent used a preventive medication. But, in 12 to 19 year olds, the use of preventive medication dropped to less than 25 percent.
"Teens may be 'under-perceivers.' They may have severe asthma, but if they can still do activities, they may not report it. And, while families may think their teen is responsible enough to take care of their medications, they're often not," Aujla said.
She said she tells the parents of her patients to be sure they watch their teen taking his or her preventive medications to be sure it's getting done. She added that it's especially important to do this even in times of good control, because that's often when kids may get more lax about using their medications.
Kit's study also found that black children and Mexican American children were significantly less likely to use preventive medications for asthma, as were uninsured people.
Aujla said part of it may be the cost of these medications, or it could be a lack of access to health care. She also said that trust may be an issue in the minority population. And, that's especially concerning because blacks have higher rates of asthma, have more severe asthma and are more likely to die from asthma, she said.
Kit said the take-away message from this study is that parents should discuss their child's asthma symptoms with their child's doctor to make sure he or she is on the right medication.
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