Trends in Preventive Asthma Medication Use Among Children and Adolescents, 1988–2008
- Brian K. Kit, MD, MPHa,b,c,
- Alan E. Simon, MDd,
- Cynthia L. Ogden, PhDa, and
- Lara J. Akinbami, MDc,d
- aDivision of Health and Nutrition Examination Surveys and
- dOffice of Analysis and Epidemiology, National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Maryland;
- bEpidemic Intelligence Service, Scientific Education and Professional Development Program Office, Centers for Disease Control and Prevention, Atlanta, Georgia; and
- cUnited States Public Health Service, Rockville, Maryland
Abstract
Objectives: To examine trends in preventive asthma medication (PAM) use among children with current asthma in the United States from 1988 to 2008.
Methods: We performed a cross-sectional analysis of PAM use among 2499 children aged 1 to 19 years with current asthma using nationally representative data from the National Health and Nutrition Examination Survey (NHANES) during 3 time periods: 1988–1994, 1999–2002, and 2005–2008. PAMs included inhaled corticosteroids, leukotriene receptor antagonists, long-acting β-agonists, mast-cell stabilizers, and methylxanthines.
Results: Among children with current asthma, there was an increase in the use of PAMs from 17.8% (SE: 3.3) in 1988–1994 to 34.9% (SE: 3.3) in 2005–2008 (P < .001 for trend). Adjusting for age, gender, race/ethnicity, and health insurance status, the odds of PAM use were higher in 2005–2008 compared with 1988–1994 (adjusted odds ratio [aOR] = 2.6; 95% confidence interval [CI]: 1.5–4.5). A multivariate analysis, combining all 3 time periods, showed lower use of PAMs among non-Hispanic black (aOR = 0.5 [95% CI: 0.4–0.7]) and Mexican American (aOR = 0.6 [95% CI: 0.4–0.9]) children compared to non-Hispanic white children. PAM use was also lower in 12 to 19 year olds compared with 1 to 5 year olds and also in children who did not have health insurance compared with those who did.
Conclusions: Between 1988 and 2008, the use of PAM increased among children with current asthma. Non-Hispanic black and Mexican American children, adolescents aged 12 to 19 years, and uninsured children with current asthma had lower use of PAM.
- asthma
- anti-asthmatic agents
- health care disparities
- medically uninsured
- quality indicators, health care
- aOR —
- adjusted odds ratio
- CI —
- confidence interval
- NAEPP —
- National Asthma Education and Prevention Program
- NHANES —
- National Health and Nutrition Examination Survey
- PAM —
- preventive asthma medication
- Accepted September 9, 2011.
- Copyright © 2012 by the American Academy of Pediatrics
