Title

Predicting Asthma Symptoms in Low-Income Children With Persistent Asthma: The Role of Medication Adherence, Depressive Symptoms and Behavior Problems

ISBN or ISSN

0091-6749

Volume

113

Issue

2

Publication Date / Copyright Date

2-2004

First Page

S100

Publisher

Mosby, Inc.

DOI Number

10.1016/j.jaci.2003.12.348

Abstract

Rationale

This study explored the relationships between child depressive symptoms and hopelessness, child behavior problems, caregiver depressive symptoms, adherence to Flovent and/or Singulair, and asthma symptoms in a low-income sample of children with persistent asthma.

Methods

Eighty-one children ages 6-11 were recruited from a primary care clinic (26%), an asthma clinic (46%), or the emergency room (28%) in an urban pediatric hospital. The child's adherence to Flovent/and or Singulair was measured by electronic monitoring devices over a 14 day period. Caregivers and children were interviewed after the monitoring period about child depressive symptoms and hopelessness, child behavior problems, caregiver depressive symptoms, and child asthma symptoms.

Results

Mean daily adherence was 65% (range=14-100%, n=70) to Flovent and 80% (range=21-100%, n=39) to Singulair. Parent- and child-reported asthma symptoms were positively and significantly correlated. Parent-reported daytime asthma symptoms were negatively correlated with Flovent and Singulair adherence, and positively correlated with caregiver-reported child behavior problems and depressive symptoms. Child-reported daytime asthma symptoms were significantly and positively correlated with child-reported depressive symptoms and hopelessness. Caregivers' self-reported depressive symptoms were positively correlated with caregiver-reported asthma symptoms for the child and negatively correlated with the child's Flovent and Singulair adherence. Regression analyses will explore the contribution of mental health variables to the prediction of asthma symptoms over and above the contribution of medication adherence.

Conclusions:

Asthma treatment providers need to consider the impact of child and caregiver mental health on asthma morbidity, particularly in cases of poor medication adherence.

Disciplines

Medicine and Health Sciences

Keywords

Child, Depressive Symptoms, Hopelessness, Behavior Problems, Caregiver, Low-Income, Persistent Asthma

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