Use of inhaled anti-inflammatory medication in children with asthma in managed care settings

Robert John Adams, Anne L. Fuhlbrigge, Jonathan A. Finkelstein, Paula Lozano, James M. Livingston, Kevin B. Weiss, Scott T. Weiss

Research output: Contribution to journalArticlepeer-review

57 Citations (Scopus)


Background Many factors affect use of inhaled therapy in asthma. Relatively little is known about current patterns of use of anti-inflammatory medication in children with asthma and whether variations occur with age and use of bronchodilator medication. Objective To study the factors associated with dispensing of anti-inflammatory (controller) asthma medication to children in 3 managed care organizations (MCOs). Methods Using automated databases, a 1-year cross-sectional study of children with asthma aged 3 to 15 years cared for in 3 MCOs was used to evaluate the association of age and other factors with controller medication use. Results A total of 13 352 children were studied. Significantly fewer children aged 3 to 5 years were dispensed any (≥1) controller medication than older children (P<.001). Among children dispensed 6 or more β-agonists, only 39% also received 5 or more controller dispensings, with adolescents significantly less likely than younger children to receive 5 or more controllers (33%; P<.001). Significant differences were seen among MCOs in proportions of patients dispensed controller medication. In a multiple logistic regression model, controlling for frequency of β-agonist dispensing and MCO, significantly lower dispensing of any controller medication was seen for those aged 3 to 5 years (odds ratio [OR], 0.8; 95% confidence interval [CI], 0.7-0.9) and for girls (OR, 0.9; 95% CI, 0.8-0.96). In contrast, for repeated (≥5) controller dispensing there were significantly fewer dispensings to adolescents (OR, 0.7; 95% CI, 0.6-0.9) and girls (OR, 0.8; 95% CI, 0.7-0.9). Conclusions There may be differences in the use of preventive asthma medication in children that are affected by age, sex, and health care organization. Few children with frequent symptoms are using controllers regularly, as is recommended by national guidelines.
Original languageEnglish
Pages (from-to)501-507
Number of pages7
Issue number4
Publication statusPublished - Apr 2001
Externally publishedYes


  • asthma prevention
  • anti-inflammatory medication
  • inhaled controller therapy


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