Elsevier

Ambulatory Pediatrics

Volume 5, Issue 5, September–October 2005, Pages 306-310
Ambulatory Pediatrics

Parental Beliefs About Medications and Medication Adherence Among Urban Children With Asthma

https://doi.org/10.1367/A05-004R1.1Get rights and content

Background.—Although national guidelines recommend controller medications for children with persistent asthma, adherence is poor. Prior studies have begun to explore parental beliefs regarding controller asthma medications and their effect on adherence.

Objective.—To describe parental beliefs about controller medications among a community-based sample of urban children with persistent asthma and to examine the relationship between parental beliefs and adherence.

Design/Methods.—Parents of 150 children with asthma completed a telephone survey as part of a larger asthma intervention. Parents of children using controller asthma medications were included in this study. A previously validated Beliefs About Medications Questionnaire (BMQ) was used, which included two subscales: necessity and concern. The relationship between parental beliefs about medications and medication adherence was assessed using bivariate linear regression and multivariate statistics.

Results.—This study included 67 children with parental report of controller medication (54% male, 61% African American, 69% Medicaid). Overall, 75% of parents strongly believed that their child's medications were necessary for their health and 34% had strong concerns about the medications. Only 22% of parents reported being completely adherent with medications. Parents with greater concern about medications were more likely to have poor adherence (P < .05). In a multivariate analysis, including both BMQ subscales and asthma severity, concern about medications significantly predicted poor medication adherence (P = .03).

Conclusions.—Parental concerns about controller medications were associated with poor medication adherence for this population of urban children with asthma. These findings highlight the importance of addressing parental concerns at the time of medication prescription.

Section snippets

METHODS

We obtained data for this study from a sample of children ages 3–7 participating in a larger, unrelated school-based intervention in 2002.23 All parents of children entering the Rochester City School district who indicated asthma on their school health assessment were contacted by telephone to assess the child's asthma severity. Children with mild persistent to severe persistent symptoms were eligible for enrollment. The response rate for the entire sample of children enrolled in the

RESULTS

Table 1 shows the demographic characteristics of the 67 children included in the sample. Fifty-four percent of the children were male. The majority of the children were African American (61%), 8% white, and 31% other racial backgrounds. Twenty-five percent of the children were Hispanic and most had Medicaid insurance (69%). Thirty-six percent of the parents described their child as having moderate to severe symptoms.

Table 2 describes the overall beliefs about medications and medication

DISCUSSION

The majority of parents of urban children with asthma in this community-based sample felt strongly that their child's medications were necessary for maintaining their child's health. However, one third of the parents had strong concerns about their child's medications. Additionally, less than one quarter of the parents reported being completely adherent with their child's controller asthma medications. Parental concerns about medications had a negative influence on medication adherence.

These

ACKNOWLEDGMENTS

The research for this article was funded by a grant from the Halcyon Hill Foundation. We wish to thank Maria Fagnano, BA, for her assistance in preparing the manuscript and Kimberly J. Sidora-Arcoleo, MPH, for her assistance with data analysis.

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