MEDICATIONS USED BY CHILDREN WITH ASTHMA LIVING IN THE INNER-CITY

Objective. The purpose of the study was to examine medication use repo rted by families participating in an urban school-based community inte rvention program and to relate this use to other social and medical va riables. Design. The design of the study was a cross-sectional questio nnaire survey. Setting. Patients and their families recruited from ele mentary schools in a community setting were interviewed between Decemb er 1991 and January 1992. Participants. A total of 508 children with a sthma were identified by school health records and teacher surveys. Th eir families confirmed the diagnosis and agreed to enter the study. Qu estionnaires were completed by 392 families. Intervention. The 392 fam ilies participated in a controlled trial of asthma education after pro viding the data that are the basis of this report. Results. More than half of the children took two or more medications for asthma. Thirty-o ne percent took theophylline alone or in combination with an adrenergi c agent; 11% took some form of daily antiinflammatory medication, eith er cromolyn (8%) or inhaled steroids (3%). The pattern of medication u se related to measures of severity and to regular visits to physicians or nurses. In general, however, children were undermedicated. A total of 78 children (20%) reported no medication or over-the-counter medic ation use, although 37% reported asthma severe enough to be associated with greater than or equal to 20 days of school missed per month, and 37% had had an emergency room visit for asthma in the past 6 months. More than half of children greater than or equal to 9 years old superv ised their own medication. Conclusions. We concluded that undermedicat ion is common in poor children with asthma living in urban areas. Anti inflammatory medications are used less commonly than in the general po pulation, and theophylline is used more often. School children may be likely to supervise their own medication.