PEDIATRICS Vol. 99 No. 1 January 1997, pp. 40-43
2-Agonist Metered Dose Inhaler Overuse:
Psychological and Demographic Profiles
Received Sep 19, 1995; accepted Jan 10, 1996.
From the Children's Rehabilitation Hospital of Thomas Jefferson University, Department of Pediatrics, Philadelphia, Pennsylvania.
Objective. To identify psychological
and demographic correlates of children and adolescents known to overuse
2-agonist metered dose inhalers (
-MDIs).
Design. During residential care for severe asthma,
demographic and psychological characteristics of 17 children and
adolescents known to be
-MDI overusers were compared with 38 asthmatic subjects of similar age without such history.
Results.
-MDI overuse occurred among all groups;
however, males, minorities, and those from lower socioeconomic groups
were overrepresented. Overusers scored significantly lower on
standardized IQ tests. Subtests of arithmetic for numeric reasoning,
comprehension for understanding of social values, and picture
completion for visual attention to detail were also significantly lower
in
-MDI overusers, as were reading achievement tests. Testing also
revealed tendencies toward dominant, shrewd, and undisciplined
personality traits in the overusers.
Conclusion. Recognition of these characteristics of
children prone to
-MDI overuse will raise the clinician's awareness
of this potential. Greater efforts and alternative approaches toward education and treatment of the at-risk patient and family are indicated.
2-agonist,
metered dose
inhaler,
overuse,
psychological,
gender,
age,
socioeconomic status,
ethnicity.
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