(Child Asthma.File photo dated 28/11/2006 of a child using an inhaler for treatment of Asthma. Issue date: Tuesday August 10, 2010. Children with asthma are more likely to be admitted to hospital in September than any other month, figures showed today. Hospital admissions for under-16s were 58% higher in September 2009 than the monthly average for the year, according to data for England from the NHS Information Centre. See PA story Health Asthma. Photo credit should read: John Giles/PA Wire URN:9294525 (Press Association via AP Images))

Children are not getting their asthma medications, says study

A new study finds parents are filling out less than half of their children’s asthma prescriptions, which worries many doctors. (Photos/Getty Images).     

The majority of children who need to be taking regular asthma medications are using them less than half of the time, according to a new study by the University of Southern California published in the Journal of the American Medical Association (JAMA). Researchers found higher out-of-pocket costs are one of the reasons why many parents are not regularly filling out their children’s asthma prescriptions, something which greatly worries doctors.

“If it is managed regularly, asthma is a preventable disease, but if it is not treated, it really impacts a child’s quality of life and it can be a serious and life-threatening disease,” says Dr. Juan Guarderas, an allergy and immunology specialist at the Mayo Clinic in Jacksonville, Florida.

At least one of every 10 children in the U.S. has asthma, according to government figures. Among Latinos, the numbers are even higher – 16 percent of Puerto Rican children have the disease, and Latino children are 60 percent more likely to have asthma than non-Latino white children, according to figures from Health and Human Services.

Dr. Guarderas says “there is a misconception in the Latino community that most kids outgrow asthma, but most children diagnosed with this chronic disease, especially after age 7, will not outgrow it.”

He adds that coughing and wheezing are symptoms of asthma, but what causes asthma is an inflammation of the airways, usually due to allergies.

“The best way to treat the root of the disease, which is the inflammation, is to give the child the daily inhaled steroids if these were prescribed by the doctor,” Dr. Guarderas adds.

Many Latino children with asthma, Dr. Guarderas points out, miss school and become physically inactive, which also leads to the problem of obesity. Not controlling their asthma limits these children’s chances to lead productive, active lives.

The USC study found that among families with insurance, an increase in out-of-pocket costs for asthma medication led to a slight decrease in the use of the medications and an increase in hospitalizations.  The researchers found that parents were better about filling out the prescriptions for children under 5, but not as good at filling out medications for older children.  Parents filled out prescriptions only about 40 percent of the time.

“The risks of not taking regular asthma medications are substantial,” says Dr. Pamela Wood, a pediatrician and clinical professor of pediatrics at the University of Texas Health Science Center in San Antonio, who sees many Latino patients.

If cost is an issue for families, doctors say there is help out there.  ”Families should work with their doctors as a team to find the best approach to treat the child’s asthma,” says Dr. Wood. “Some medications have lower co-pays, and there are resources out there for families,” she says. Some drug companies offer rebates; some even give out free medication for families in need.

Cost is not the only reason why a majority of parents do not give their children asthma medication on a daily basis.

“Like many chronic diseases, sometimes you feel better,” explains Dr. Wood. If a child has been taking inhaled steroids, the benefits can last for weeks, so a parent might think the child is okay – until the child gets worse.

Other parents have a “fear” of the word “steroid,” says Dr. Juan Garderas.  But long-term studies have proven inhaled steroids are safe and do not interfere with a child’s growth and development.

Families, and in particular teens, might not want to be associated with a “chronic disease,” these doctors say.  But when asthma sufferers take regular medications, it is completely manageable.

Dr. Guarderas advises families to meet with their doctor to figure out ways to make daily use an easier thing, like taking it once a day at bedtime.  What is not wise, say pulmonologists and allergists, is to just stop without consulting a doctor.

“In fact, I tell my patients that about 30 percent of athletes in many U.S. Olympic teams have asthma,” Dr. Guarderas says.  ”It does not have to be a limiting factor.”

       

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