What really happens in the home: the medication environment of urban minority youth

Published online: December 1, 2016

Urban minority youth diagnosed with asthma have a disproportionately high burden of asthma morbidity and mortality.  Understanding the home medication environment and its relation to medication adherence can shape interventions to improve health outcomes.

In a recent article published in The Journal of Allergy and Clinical Immunology: In Practice, Pappalardo and colleagues describe that the home medication environment of a high risk pediatric cohort reveals lack of proper medications, devices, and poor inhaler technique.  Baseline data from two cohorts of minority youth with asthma in Chicago were combined for cross-sectional analysis.  Bilingual research assistants (RAs) observed children’s asthma medications and inhaler technique and collected data in the home, asking caregivers and children to self-report medications using pictures.  

The sample contained 175 mainly Latino youth (85.6%) ranging from 5-18 years old.  Most were on public insurance (80%) and had uncontrolled asthma by self-report (89.7%).  Only 27.4% of children had a spacer, 74.9% had a quick-relief medicine and 48.6% had any controller medicine. Only one child was able to properly demonstrate 100% of the inhaler steps and 35.6% achieved >70% of inhaler steps.

This study encourages frequent objective review of medications available in the home, reinforced inhaler technique training for children and caregivers, and highlights the need for multi-level interventions to help address adherence.

The Journal of Allergy and Clinical Immunology: In Practice is an official journal of the AAAAI, focusing on practical information for the practicing clinician.
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