Sleath Study Explores Problems N.C. Children Have with Asthma Medicine

Divisions Faculty Pharmaceutical Outcomes and Policy Research,

Grayson Mendenhall
July 23, 2010

More than 85 percent of North Carolina children who have asthma need more help understanding how to take their medications, according to a new study from the UNC Eshelman School of Pharmacy at the University of North Carolina at Chapel Hill.

The study, led by Betsy Sleath, PhD, a professor at the pharmacy school, looked at the types of medication problems and concerns reported by asthmatic children and their caregivers in North Carolina and examined the association between child and caregiver demographic and sociocultural characteristics and medication problems they reported.

“Asthma is a disease of devices. It’s usually not as simple as taking a pill,” Sleath says. “Studies have found that anywhere from 30 percent to nearly 70 percent of individuals do not use their inhalers correctly, which results in a lot of wasted medicine and less than optimal management of a patient’s condition.”

Eighty-seven percent of the 320 children ages eight to sixteen in the study reported a problem or concern in using their asthma medications. The study subjects all had mild, moderate, or severe persistent asthma were recruited for the study at five pediatric practices in nonurban areas across North Carolina.

Approximately 40 percent of children reported side effects and a similar percent stated that it was hard to understand the directions on their medicines.
Sixty percent reported that it was hard to remember when to take their medicines.
Girls and nonwhite children were significantly more likely to report that they were not sure how to use an inhaler than boys and white children.
Younger and nonwhite children were significantly more likely to report that it was hard to understand the directions on their medicines than older and white children.
Caregivers were most likely to report that their children were bothered a little or a lot by side effects (31 percent ) and a similar percent (29 percent) were not sure their children were using their inhalers properly.
Caregivers without Medicaid were significantly more likely to report difficulty paying for the asthma medications.

“These results are a call to action,” Sleath says. “Kids may be missing school, parents may be missing work, and money is potentially being wasted simply because we are not making sure that asthmatic children understand how and when to take their medicines. It is up to those of us in health care to make sure to take the time to talk with asthmatic children about their medicines”.

The study, “Child- and Caregiver-Reported Problems and Concerns in Using Asthma Medications,” is published in the Journal of Asthma (August 2010). Sleath is interim chair of the Division of Pharmaceutical Outcomes and Policy at the UNC pharmacy school and The other authors of the paper are Guadalupe X. Ayala, PhD, MPH, of the San Diego State University Graduate School of Public Health; Stephanie Davis, MD, of the UNC School of Medicine; Chris Gillette, Dennis Williams, PharmD; and Deidre Washington, PhD; of the UNC Eshleman School of Pharmacy; Karin Yeatts, PhD, of the UNC Gillings School of Global Public Health; and Gail Tudor, PhD; Husson University School of Science and Mathematics.