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Factors associated with medication adherence in school-aged children with asthma

Amy H.Y. Chan, Alistair W. Stewart, Juliet M. Foster, Edwin A. Mitchell, Carlos A. Camargo Jr, Jeff Harrison
ERJ Open Research 2016 2: 00087-2015; DOI: 10.1183/23120541.00087-2015
Amy H.Y. Chan
1School of Pharmacy, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
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  • For correspondence: a.chan@auckland.ac.nz
Alistair W. Stewart
2Epidemiology & Biostatistics, School of Population Health, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
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Juliet M. Foster
3Woolcock Institute of Medical Research, University of Sydney, Sydney, Australia
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Edwin A. Mitchell
4Dept of Paediatrics: Child and Youth Health, School of Medicine, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
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Carlos A. Camargo Jr
5Dept of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
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Jeff Harrison
1School of Pharmacy, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
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Tables

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  • TABLE 1

    Characteristics of 101# participants in the analytical cohort and unadjusted analyses of 20 factors associated with adherence

    VariableParticipantsEffect sizep-value
    Age years8.9±2.7−1.5% (95% CI−3.2–0.2%) per year0.09
    Sex
     Male5226 (15–43)0.05
     Female4940 (19–60)
    Qualification of primary caregiver 
     None836 (11–42)
     Secondary school2228 (15–53)0.81
     Tertiary4526 (12–47)
     Postgraduate2242 (21–51)
     Missing4
    Ethnicity
     Māori1019 (13–44)
     European3926 (17–43)
     Pacific Peoples2028 (13–40)0.002
     Middle Eastern/Latin American/African435 (5–68)
     Asian1947 (30–83)
     Other931 (21–46)
    Deprivation index¶6.0±2.7+0.002% (95% CI−1.7–1.7%) per deprivation scale0.99
    People in household4.8±1.9; 98#−3.4% (95% CI−5.8– −0.1%) per person added to household0.005
    Family status
     Single+3526 (15–47)0.39
     Not single§6532 (18–49)
     Missing1
    Able to discuss concerns with the healthcare professional looking after the child
     No824 (6–49)0.68
     Yes9231 (17–48)0.68
     Missing1
    Delayed picking up medications due to cost
     No7831 (16–48)
     Yes2126 (16–49)0.87
     Missing2
    Delayed seeing the doctor due to cost
     No6931 (16–54)
     Yes3028 (16–46)0.28
     Missing2
    Easy access to doctor
     No1037 (18–52)0.91
     Yes9030 (17–48)0.91
     Missing1
    Easy access to pharmacy
     No220 (7– -)0.37
     Yes9930 (17–48)
    Age at asthma diagnosis years3.3±2.3−1.7% (95% CI−3.7–0.3%) per year0.09
    Childhood Asthma Control Test18.8±4.2; 100#+0.9% (95% CI−0.2–2.0%) per 1 point on the Childhood Asthma Control Test0.11
    Asthma Morbidity Score9.2±2.6; 100#−0.3% (95% CI−2.1–1.5%) per 1 point on the Asthma Morbidity Score0.73
    Medication side-effects
     No9129 (17–48)0.84
     Yes1033 (11–46)
    Healthcare provider involved in routine follow-up asthma care
     None (no follow-up)272 (60– -)
     General practitioner7426 (12–43)0.003
     Specialist531 (23–61)
     Asthma nurse1551 (15–85)
     Multiple providers546 (26–61)
    Asthma Responsibility Questionnaire23.7±8.1−0.2% (95% CI−0.7–0.4%) per 1 point of Asthma Responsibility Questionnaire0.53
    Asthma Knowledge Test19.1±2.7+0.7% (95% CI−1.0–2.4%) per 1 point of Asthma Knowledge Test0.42
    Learning styles
     Aural6429 (17–48)0.76
     Non-aural3030 (14–49)
     Missing7
    • Data are presented as mean±sd, n or median (interquartile range), unless otherwise stated. Bold data indicates statistical significance. #: data do not total 101 for some parameters due to missing data from participants who did not completed the relevant questionnaire(s). Median (interquartile range) adherence for the total sample (n=101) was 30% (17–48%); ¶: based on the NZDep2006 deprivation index (1=least deprived, 10=most deprived). This is an indicator of socioeconomic deprivation of the area where the individual resides. Scores are derived from census data on income, home ownership, employment, qualifications, family structure, housing, access to transport and communications; +: single parent/divorced/separated /widowed/single; §: de facto/extended whanau/married.

  • TABLE 2

    Multivariable regression analysis with objective adherence as independent variable#

    VariableEffect sizep-value
    Sex12±4%0.005
    Asian ethnicity19±5%<0.001
    People in the household−3.0±1.0% per person0.01
    Age at asthma diagnosis years−2.7±0.9% per year0.004
    • Data are presented as change±se. #: n=87.

Additional Files

  • Tables
  • Disclosures

    Files in this Data Supplement:

    • C.A. Carmargo Jr
    • A.H.Y. Chan
    • J.M. Foster
    • J. Harrison
    • E.A. Mitchell
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Factors associated with medication adherence in school-aged children with asthma
Amy H.Y. Chan, Alistair W. Stewart, Juliet M. Foster, Edwin A. Mitchell, Carlos A. Camargo, Jeff Harrison
ERJ Open Research Jan 2016, 2 (1) 00087-2015; DOI: 10.1183/23120541.00087-2015

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Factors associated with medication adherence in school-aged children with asthma
Amy H.Y. Chan, Alistair W. Stewart, Juliet M. Foster, Edwin A. Mitchell, Carlos A. Camargo, Jeff Harrison
ERJ Open Research Jan 2016, 2 (1) 00087-2015; DOI: 10.1183/23120541.00087-2015
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