Caregiver Depressive Symptoms and Primary Medication Nonadherence in Children With Asthma.

Introduction: The purpose of this study was to identify risk factors for primary medication nonadherence among low-income minority children with persistent asthma.

Method: Data were from an environmental control and educational intervention for children with uncontrolled asthma who were treated in the emergency department for an asthma exacerbation. Presence or absence of pharmacy records for child asthma medications was the outcome of interest.

Characteristics of inner-city children with life-threatening asthma.

Background: Intensive care unit (ICU) admission is a risk factor for fatal asthma. Little is known about risk factors for pediatric ICU admissions for asthma.

Objective: To examine characteristics of underserved minority children with prior ICU admissions for asthma.

Children with poorly controlled asthma: Randomized controlled trial of a home-based environmental control intervention.

Background: Few trials have tested targeted environmental control (EC) interventions based on biomarkers of second hand smoke (SHS) exposure and allergen sensitization in reducing asthma emergency department (ED) visits in children with poorly controlled asthma.

Methods: Overall, 222 children with poorly controlled asthma were randomized into a home-based EC intervention (INT) or control (CON) group and followed for ED visits over 12 months. All children received allergen-specific IgE serologic testing and SHS exposure biomarker testing to inform the EC intervention.

Association between second hand smoke (SHS) exposure and caregiver stress in children with poorly controlled asthma.

: Urban children with asthma experience high rates of second hand smoke (SHS) exposure. The objective was to examine whether SHS exposure is associated with symptom frequency in children with poorly controlled asthma. : Children were enrolled in a RCT to test the efficacy of an environmental control behavioral intervention versus an attention control group and followed over 12 months.

Very Poorly Controlled Asthma in Urban Minority Children: Lessons Learned.

Background: Very poorly controlled (VPC) asthma in children is associated with ongoing acute exacerbations but factors associated with VPC are understudied.

Objective: To examine the risk factors associated with VPC asthma in urban minority children.

Methods: This descriptive study examined asthma control levels (well-controlled [WC], not well-controlled [NWC], and VPC) at baseline and 6 months in children participating in an ongoing randomized controlled trial of an emergency department/home environmental control intervention.

Factors associated with poor controller medication use in children with high asthma emergency department use.

Background: Understanding health and social factors associated with controller medication use in children with high-risk asthma may inform disease management in the home and community.

Objective: To examine health and social factors associated with the Asthma Medication Ratio (AMR), a measure of guideline-based care and controller medication use, in children with persistent asthma and frequent emergency department (ED) use.

Methods: Study questionnaires, serum allergen sensitization, salivary cotinine, and pharmacy record data were collected for 222 children enrolled from August 2013 to February 2016 in a randomized clinical trial that tested the efficacy of an ED- and home-based intervention.

Stress and Quality of Life in Urban Caregivers of Children With Poorly Controlled Asthma: A Longitudinal Analysis.

Introduction: The intent of this analysis was to examine the longitudinal effects of risk and protective factors on quality of life (QOL) in caregivers of minority children with asthma.

Method: Caregivers (n = 300) reported on demographics, child asthma characteristics, daily asthma caregiving stress, general life stress, social support, and QOL. Latent growth curve modeling examined changes in QOL across 12 months as a function of stress, asthma control, and social support.

Factors associated with high short-acting β2-agonist use in urban children with asthma.

Background: One goal of guideline-based asthma therapy is minimal use of short-acting β₂ agonist (SABA) medications. Inner-city children with asthma are known to have high SABA use.

Objective: To examine factors associated with high SABA use in inner-city children with asthma.

Vancomycin-associated nephrotoxicity in adult medicine patients: incidence, outcomes, and risk factors.

Objective: The prevalence of vancomycin-associated nephrotoxicity (VAN) is reported to vary from 1.0-42.6%, with most data from critically ill patients.

Improving preventive care in high risk children with asthma: lessons learned.

Objectives: Rates of preventive asthma care after an asthma emergency department (ED) visit are low among inner-city children. The objective of this study was to test the efficacy of a clinician and caregiver feedback intervention (INT) on improving preventive asthma care following an asthma ED visit compared to an attention control group (CON).

Methods: Children with persistent asthma and recent asthma ED visits (N = 300) were enrolled and randomized into a feedback intervention or an attention control group and followed for 12 months.

Prescription fill patterns in underserved children with asthma receiving subspecialty care.

Background: Children with asthma receiving specialty care have been found to have improved asthma outcomes. However, these outcomes can be adversely affected by poor adherence with controller medications.

Objective: To analyze pharmacy fill patterns as a measure of primary adherence in a group of underserved minority children receiving allergy subspecialty care.

Stress and quality of life in caregivers of inner-city minority children with poorly controlled asthma.

Introduction: Caregiver quality of life (QOL) is known to influence asthma management behaviors. Risk factors for low caregiver QOL in families of inner-city children with asthma remain unclear. This study evaluated the interrelationships of asthma control, stress, and caregiver QOL.

Factors associated with completion of a behavioral intervention for caregivers of urban children with asthma.

Background: Rates of preventive follow-up asthma care after an acute emergency department (ED) visit are low among inner-city children. We implemented a novel behavioral asthma intervention, Pediatric Asthma Alert (PAAL) intervention, to improve outpatient follow-up and preventive care for urban children with a recent ED visit for asthma.

Objective: The objective of this article is to describe the PAAL intervention and examine factors associated with intervention completers and noncompleters.

Factors associated with second-hand smoke exposure in young inner-city children with asthma.

Objectives: To examine the association of social and environmental factors with levels of second-hand smoke (SHS) exposure, as measured by salivary cotinine, in young inner-city children with asthma.

Methods: We used data drawn from a home-based behavioral intervention for young high-risk children with persistent asthma post-emergency department (ED) treatment (N = 198). SHS exposure was measured by salivary cotinine and caregiver reports.

Influence of caregiver and provider communication on symptom days and medication use for inner-city children with asthma.

Background: Effective pediatric guideline-based asthma care requires the caregiver to accurately relay the child's symptom frequency, pattern of rescue and controller medication use, and level of asthma control to the child's primary care clinician.

Objective: This study evaluated the longitudinal effects of a caregiver-clinician asthma communication education intervention (ACE) relative to an asthma education control group (CON) on symptom days and controller medication use in inner-city children with asthma.

Participants And Methods: 231 inner-city children with asthma, recruited from urban pediatric emergency departments (EDs) and community practices, were followed for 12 months.

Factors affecting primary care provider and caregiver concordance for pediatric asthma medications.

Background: Lack of discussion regarding actual asthma medication use by physicians with caregivers of children with asthma may result in low caregiver and physician concordance about prescribed asthma medications.

Objective: The primary objective was to examine the concordance between primary care providers (PCP) and caregivers regarding child asthma medication use.

Methods: Current asthma medications in the home with verification from each child's PCP were obtained for 231 underserved children with persistent asthma.

Seasonal patterns of controller and rescue medication dispensed in underserved children with asthma.

Objective: To determine whether temporal trends exist for short-acting beta agonist (SABA), oral corticosteroid (OCS), and anti-inflammatory prescription fills in children with persistent asthma.

Method: This was a longitudinal analysis of pharmacy record data and health information data obtained by parent report over 12 months for children with persistent asthma 2 to 9 years of age. Eligible children had to report current nebulizer use and one or more emergency department visits or hospitalizations within the past 12 months.

The effect of violence on asthma: are our children facing a double-edged sword?

Low income, urban children with asthma are experiencing community violence that may contribute to asthma morbidity. The objective of this study was to examine the relationship between caregiver report of feeling unsafe, seeing community violence or child seeing community violence and asthma morbidity and health care utilization. Two hundred thirty-one caregivers of children with asthma enrolled in an asthma,education, intervention reported perceptions of safety and violence exposure in six months and frequency of child asthma symptoms, emergency department (ED), primary care (PCP) visits and hospitalizations over 12 months.

Factors affecting pharmacists' pediatric asthma counseling.

Objective: To explore various factors that may influence community pharmacists' pediatric asthma counseling.

Design: Cross-sectional.

Setting: Maryland from September 2002 through March 2003.

Assessment of hospice nurses' technique in the use of inhalers and nebulizers.

Dyspnea, a common distressing end-of-life symptom, is treated with oral (i.e., opioids and anxiolytics) and inhaled medications (anti-inflammatory and bronchodilator agents).

Concordance of Medicaid and pharmacy record data in inner-city children with asthma.

Background: Management of asthma involves adherence to medication regimens. Assessing adherence is difficult for health care providers and researchers. Self-reported medication use is subjective, so objective methods of data collection for medication use are frequently used in asthma research.

Patterns of inhaled antiinflammatory medication use in young underserved children with asthma.

Background: Asthma guidelines advocate inhaled corticosteroids as the cornerstone treatment of persistent asthma, yet several studies report underuse of inhaled corticosteroids in children with persistent asthma. Moreover, few studies use objective pharmacy data as a measure of drug availability of asthma medications. We examined factors associated with the use of inhaled corticosteroids in young underserved children with persistent asthma using pharmacy records as their source of asthma medications.