Prevalence and characteristics of medication sharing behavior in a pediatric Medicaid population with asthma

Valet, Robert S.; Gebretsadik, Tebeb; Minton, Patricia A.; Woodward, Kimberly; Wu, Ann Chen; Hartert, Tina V.; Larkin, Emma K.

doi:10.1016/j.anai.2014.11.007

Cited by 8 publications

(9 citation statements)

References 8 publications

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“…We are unaware of other teen asthma programs addressing this issue, and the behavior is not widely reported or measured in the literature. Valet et al reported on the sharing of asthma medications among Medicaid enrollees and found 16% reported doing so [12], compared to our 20.3%. In their study, sharing medications was not associated with Emergency Department visits in the previous 6 months or use of rescue inhalers in the previous 14 days.…”

Section: Discussioncontrasting

confidence: 72%

“…In their study, sharing medications was not associated with Emergency Department visits in the previous 6 months or use of rescue inhalers in the previous 14 days. [12] Although we are not able to detect an overall trend at Phase II for the Puff City intervention effect, the ancillary marker study was conducted with a focus on identifying a sub-group of patients who would most benefit from Puff City. This approach of identifying an enriched population is used to confirm the efficacy of an intervention with a much smaller sample size.…”

Section: Discussionmentioning

confidence: 92%

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Phase II trial of web-based tailored asthma management intervention in adolescents at clinics

Lü

Zhang

Ownby

et al. 2019

Contemporary Clinical Trials

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Clinical trials are critical for medical decision-making; however, conduct is costly and labor intensive. Traditionally, clinical trials are conducted in a controlled environment with a restricted patient population. In addition to the use of electronic initiatives (e-initiatives) such as the use of electronic medical records (EMR) for patient identification, recruitment and data collection, pragmatic clinical trials promote patient enrollment in a "real world" setting with fewer exclusion criteria and less need for research infrastructure. The pragmatic trial also uses comparative adaptive methods and approaches to ensure results provide realworld evidence, i.e., evidence that study execution and data analysis are translatable to practice. Puff City, a web-based, asthma management program for urban adolescents with asthma, has been evaluated in Detroit Public High Schools [1] [2], and results of these school-based randomized trials were promising for potential dissemination beyond schools [1] [2]. To demonstrate pragmatic approaches to conduct of a randomized trial, we extended the Puff City program to a clinical setting and conducted a seamless Phase II/III pragmatic trial of the program in a group of urban, primary care clinics.

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Section: Discussioncontrasting

confidence: 72%

Section: Discussionmentioning

confidence: 92%

Phase II trial of web-based tailored asthma management intervention in adolescents at clinics

Lü

Zhang

Ownby

et al. 2019

Contemporary Clinical Trials

View full text Add to dashboard Cite

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“…4 In a small study of pediatric patients with asthma, 16% of caregivers reported sharing asthma medications. 11 These rates of sharing are slightly lower than those reported in the literature for adolescents and adults, in which several studies report rates of approximately 20%. [1][2][3][5][6][7]12 Lower reported rates of sharing in children may indicate that caregivers have a greater concern for the hazards of sharing medications with their children or may be because of underreporting.…”

Section: Discussionmentioning

confidence: 74%

Frequency of and Factors Associated With Prescription Medication Sharing Within Families

2019

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Objectives: Limited literature has investigated caregiver sharing of prescription medications with children. Our primary aim was to determine the frequency of and factors associated with prescription medication sharing within families. Our secondary aim was to determine the source and type of medications shared. Methods:We conducted a survey of a convenience sample of caregivers of children 1 to 17 years in a pediatric emergency department. The survey was developed through literature review, iterative feedback, and pilot testing on caregivers. We used logistic regression to identify factors associated with any history of medication sharing with a child in the home (primary outcome). Results:We enrolled 550 primary caregivers; 68 of the 535 analyzed (12.7%; 95% confidence interval [CI], 10.0-15.8) reported prescription medication sharing with their child/children. Of those who shared, 50 (73.5%) shared asthma medications and 14 (20.6%) shared antibiotics. Of the caregivers who shared prescription medications, 70.6% shared a medication for one child with another child, whereas 33.8% of caregivers shared their own or another adult's medication with their child. A child in the home with asthma (adjusted odds ratio [aOR], 3.35; CI, 1.82-6.17), a greater number of children in the household (aOR, 1.29; CI, 1.04-1.60), and a caregiver who previously shared medications with other family members and/or friends (aOR, 4.10; CI, were factors independently associated with medication sharing.Conclusions: Prescription medication sharing within families is common and most often involves asthma medications. We identified several factors associated with prescription medication sharing that could be used to target caregivers for preventative interventions.

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“…However, prior literature indicates that when families report any sharing of asthma medications, they are likely to report sharing both types of medication. [25] Finally, caregivers may have been subjected to social desirability bias when they reported preventive medication use at baseline.…”

Section: Discussionmentioning

confidence: 99%

Identifying which children with persistent asthma have preventive medications available at home

et al. 2019

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Objective: To compare caregiver-reported preventive medication use and pharmacy data with medications available at home for children with persistent asthma, and identify factors associated with having preventive medication at home. Methods:We analyzed baseline data from the School-Based Telemedicine Enhanced Asthma Management (SB-TEAM) study, including medication use, symptoms, and demographics. Research assistants documented all asthma medications available during home visits. We reviewed pharmacy records for a subset of children. Bivariate and multivariate analyses identified factors associated with having any preventive medication in the home. Results:We included 335 children (mean 7.7yrs, 56% Black, 34% Hispanic, 77% Medicaid; participation 79%). Most caregivers (69%) reported preventive medication use, yet only 45% had preventive medication at home. Compared to families with preventive medication at home, more families without preventive medication reported discontinuous insurance in the prior year (7% v 15%, p=0.02) and medication sharing (22% v 32%, p=0.04). For the subset with pharmacy records (n=192), 40% filled a preventive medication in the past year and 15% had a preventive medication at home. In multivariate analyses, children were less likely to have preventive medication at home when caregivers reported no preventive medication use in the past 2 weeks (OR 0.25; 95%CI 0.14,0.43), discontinuous insurance (OR 0.42; 95%CI 0.19,0.97), medication sharing (OR 0.54; 95%CI 0.32,0.91), or caregiver education ≥HS (OR 0.59; 95%CI 0.35,0.99). Conclusion:Among urban children with persistent asthma, neither caregiver-report nor pharmacy data reflect home preventive medication availability. Inquiring about insurance coverage and medication sharing may improve preventive medication availability for these children.

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Prevalence and characteristics of medication sharing behavior in a pediatric Medicaid population with asthma

Cited by 8 publications

References 8 publications

Phase II trial of web-based tailored asthma management intervention in adolescents at clinics

Phase II trial of web-based tailored asthma management intervention in adolescents at clinics

Frequency of and Factors Associated With Prescription Medication Sharing Within Families

Identifying which children with persistent asthma have preventive medications available at home

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