RATIONALE: Medication knowledge does not always influence adherence behaviors, but improving asthma knowledge has been associated with positive health outcomes.METHODS: Parent knowledge of asthma medications and self-reported asthma symptoms, asthma management, and health beliefs were studied in children with persistent asthma enrolled in a randomized controlled education and communication intervention study.RESULTS: Sixty-seven children (mean 8.4 years, range 7-12), predominantly male (70.1%), African-American (95.5%) and Medicaid-insured (85.1%) were included. 49.3% of parents incorrectly listed quick-relief (RM) as controller medications (CM). Neither gender nor insurance status were associated with knowing controller medications (KNOWS). KNOWS were more likely to report having an Action Plan (61.8% vs 36.4%, p=0.038), using CM even when asymptomatic (47.1% vs 21.2%, p=0.026), agreeing that CM prevents their child's asthma from getting worse (88.2% vs 63.6%, p=0.023) and decreases school absences (85.3% vs 60.6%, P=0.023). KNOWS were more likely to disagree that they give CM only when having breathing problems (73.5% vs 30.3%, p=0.0004), but were more likely to report RM use within last 4 weeks (76.5% vs 51.5%, p=0.033). KNOWS were more likely to disagree with statements that it is difficult to make child take medication when well (85.3% vs 51.5%, p=0.003) and that daily CM use decreases effectiveness (73.5% vs 48.5%, p=0.036).CONCLUSIONS: Only half of parents correctly listed their child's controller medications. Although these parents had better medication knowledge, reported better asthma management practices and reduced school absences with regular use of controllers, rescue medication use was higher in those subjects. RATIONALE: Medication knowledge does not always influence adherence behaviors, but improving asthma knowledge has been associated with positive health outcomes. METHODS: Parent knowledge of asthma medications and self-reported asthma symptoms, asthma management, and health beliefs were studied in children with persistent asthma enrolled in a randomized controlled education and communication intervention study. RESULTS: Sixty-seven children (mean 8.4 years, range 7-12), predominantly male (70.1%), African-American (95.5%) and Medicaid-insured (85.1%) were included. 49.3% of parents incorrectly listed quick-relief (RM) as controller medications (CM). Neither gender nor insurance status were associated with knowing controller medications (KNOWS). KNOWS were more likely to report having an Action Plan (61.8% vs 36.4%, p=0.038), using CM even when asymptomatic (47.1% vs 21.2%, p=0.026), agreeing that CM prevents their child's asthma from getting worse (88.2% vs 63.6%, p=0.023) and decreases school absences (85.3% vs 60.6%, P=0.023). KNOWS were more likely to disagree that they give CM only when having breathing problems (73.5% vs 30.3%, p=0.0004), but were more likely to report RM use within last 4 weeks (76.5% vs 51.5%, p=0.033). KNOWS were more likely to disagree with statements that it is difficult to make child take medication when well (85.3% vs 51.5%, p=0.003) and that daily CM use decreases effectiveness (73.5% vs 48.5%, p=0.036). CONCLUSIONS: Only half of parents correctly listed their child's controller medications. Although these parents had better medication knowledge, reported better asthma management practices and reduced school absences with regular use of controllers, rescue medication use was higher in those subjects.

RATIONALE: Non-Traditional and Alternative Therapy (CAM) use is increasing. Whether CAM use is associated with asthma prescription utilization is unknown. Our objectives were to:1) Characterize CAM use in inner-city, underserved children with asthma2) Identify differences in traditional asthma prescription fill patterns between CAM users (CAM+) and non-users (CAM-).METHODS: Data were obtained from study questionnaires (baseline, 6, 12 months) and prescription (Rx) records of children with persistent asthma enrolled in a randomized clinical trial. Parents were asked, "Many people find other ways to help their children's asthma/breathing problem. Have you ever tried using home remedies (e.g., herbal teas) or medicines that you can buy without a prescription?" to ascertain CAM use.RESULTS: Complete survey and prescription data were available for 180 children ages 2-9. CAM use was identified in 29.4% of children. Most frequently encountered CAM included herbal teas (15%) and supplements (15%), manual (6%) and topical (3%) treatments. Humidification (28%), food/kitchen remedies (18%), over-the-counter medications (12%) and body position change (3%) were also reported. CAM+ filled 50% fewer inhaled corticosteroids (ICS) than CAM- (p≤0.047) at baseline. At 12 months, ICS use increased, but remained low in both groups (p=0.072). CAM+ were twice as likely to fill only short-acting beta-agonists (SABA) (p≤0.025) and were less likely to fill at least one controller (p≤0.017). The number of SABA and oral corticosteroids filled did not differ between groups.CONCLUSIONS: CAM use was prevalent in this sample of underserved children with asthma and was associated with negative prescription fill patterns. RATIONALE: Non-Traditional and Alternative Therapy (CAM) use is increasing. Whether CAM use is associated with asthma prescription utilization is unknown. Our objectives were to: 1) Characterize CAM use in inner-city, underserved children with asthma 2) Identify differences in traditional asthma prescription fill patterns between CAM users (CAM+) and non-users (CAM-). METHODS: Data were obtained from study questionnaires (baseline, 6, 12 months) and prescription (Rx) records of children with persistent asthma enrolled in a randomized clinical trial. Parents were asked, "Many people find other ways to help their children's asthma/breathing problem. Have you ever tried using home remedies (e.g., herbal teas) or medicines that you can buy without a prescription?" to ascertain CAM use. RESULTS: Complete survey and prescription data were available for 180 children ages 2-9. CAM use was identified in 29.4% of children. Most frequently encountered CAM included herbal teas (15%) and supplements (15%), manual (6%) and topical (3%) treatments. Humidification (28%), food/kitchen remedies (18%), over-the-counter medications (12%) and body position change (3%) were also reported. CAM+ filled 50% fewer inhaled corticosteroids (ICS) than CAM- (p≤0.047) at baseline. At 12 months, ICS use increased, but remained low in both groups (p=0.072). CAM+ were twice as likely to fill only short-acting beta-agonists (SABA) (p≤0.025) and were less likely to fill at least one controller (p≤0.017). The number of SABA and oral corticosteroids filled did not differ between groups. CONCLUSIONS: CAM use was prevalent in this sample of underserved children with asthma and was associated with negative prescription fill patterns.

RATIONALE: This study investigated relationships between pharmacy refills and asthma outcomes in asthmatic children. METHODS: Caregivers of 175 children with persistent asthma were interviewed about asthma-related healthcare utilization and activity restriction. The children's medication histories were obtained from pharmacies and evaluated for short-acting β2 agonist (SAB), oral steroid (POS), inhaled corticosteroid (ICS), and leukotriene modifiers (LTM). High SAB was defined as 3 or more MDI equivalents and high POS was defined as >1 prescription within a 6 month period. Outcomes were analyzed by high POS & SAB. RESULTS: The children were primarily African American (88%), Medicaid insured (81%) with a mean age of 5.15 yrs and classified with persistent asthma (91%). Outcomes included: hospitalizations (mean 0.25, range 0-3), ED visits (mean 1.37, range 0-28) and asthma-related activity restriction (58%). Overall, 13% were high SAB and 15% were high POS. In the high SAB group, 70% filled both ICS & LTM, 13% filled ICS, 13% filled LTM and 4.5% filled neither. The high POS group filled ICS & LTM (54%), ICS alone (35%) and neither (11.5%). Those with high SAB were significantly older (6.0 vs 5.0 years) and had more activity restriction (77% vs 55%, p=0.05). High POS was associated with significantly more hospitalizations (0.69 vs 0.22, p=0.007). CONCLUSIONS: The children with persistent asthma in this study overfilled SAB and POS despite use of controllers. This was associated with activity restriction and hospitalizations, but not asthma severity or asthma-related ED visits.