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Huo M, Zhao R, Deng X, Wang Y, Liu Q, Yan J, Yu H. Psychometric assessment of the Adherence to Asthma Medication Questionnaire in asthma patients in China: a validation study. J Asthma 2024; 61:300-306. [PMID: 37830743 DOI: 10.1080/02770903.2023.2267142] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 10/01/2023] [Indexed: 10/14/2023]
Abstract
BACKGROUND Patients' medication adherence plays a critical role in the treatment and rehabilitation of disease. However, few tools are currently available that can be used to identify the reasons for their nonadherence with their medication regimens. It is possible to evaluate both the level of medication adherence of a patient as well as the reasons for it using the Adherence to Asthma Medication Questionnaire (AAMQ). The purpose of this study was to adapt the AAMQ for use in Chinese patients and a variety of asthma patients. METHODS A total of 242 asthma patients were recruited from Jinzhou in China. The Adherence to Asthma Medication Questionnaire was translated and back-translated using the Brislin translation model. Test-retest reliability, internal consistency, and stability all play a large role in determining the reliability of a scale. Confirmatory factor analysis was used to examine the scale's construct validity, and expert consultation was used to verify the scale's content validity. Statistics were deemed significant at p < 0.05. RESULTS The Cronbach's α value of the Chinese version of the AAMQ was 0.866, and the coefficient values for the three domains ranged between 0.702 and 0.798. The split-half reliability and stability values were 0.794 and 0.772, respectively. The content validity index of the scale (S-CVI) was 0.923, and the content validity index of the level of scale entry was 0.857-1.000. According to the confirmatory factor analysis, the chi-square degreed of freedom were 1.484, and the model fitting indices were all within normal limits. CONCLUSIONS The AAMQ had good reliability and validity for asthmatic patients. The results of the scale's assessment can be used as a criterion for medication adherence among asthmatic patients and to understand the causes. This study provides a reference for solving the problem of medication adherence among asthma patients and implementing targeted nursing measures. PATIENT OR PUBLIC CONTRIBUTION Gratitude is extended to all individuals collaborating in completing the survey and to the author.
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Affiliation(s)
- Mingshu Huo
- School of Nursing, Jinzhou Medical University, Liaoning, China
| | - Rui Zhao
- School of Nursing, Jinzhou Medical University, Liaoning, China
| | - Xiaoxue Deng
- School of Nursing, Jinzhou Medical University, Liaoning, China
| | - Ying Wang
- Department of Respiratory Medicine, The First Affiliated Hospital of Jinzhou Medical University, Liaoning, China
| | - Qiaoli Liu
- School of Nursing, Jinzhou Medical University, Liaoning, China
| | - Jiarong Yan
- School of Nursing, Jinzhou Medical University, Liaoning, China
| | - Hongyu Yu
- School of Nursing, Jinzhou Medical University, Liaoning, China
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2
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Kolmodin MacDonell K, Bruzzese JM, Dinaj-Koci V, Gibson-Scipio W, Starbird W, Hall A, Dailey R, Jacques-Tiura AJ, Wang B. Predictors of adherence to controller medication in urban African American emerging adults with uncontrolled persistent asthma. J Asthma 2023; 60:1877-1884. [PMID: 37026716 DOI: 10.1080/02770903.2023.2196566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 03/21/2023] [Accepted: 03/24/2023] [Indexed: 04/08/2023]
Abstract
BACKGROUND African American emerging adults tend to have low adherence to asthma controller medication, as well as a disproportionate burden of asthma morbidity and mortality. This study explored constructs from the Information-Motivation-Behavioral Skills model as predictors of controller medication adherence in urban African Americans ages 18-29 (N=152) with uncontrolled asthma using multiple measures of self-reported adherence. METHODS Structural equation modeling (SEM) was employed to test the hypothesized mediation model that specified the relationship among psychological distress, substance use, asthma knowledge, motivation, self-efficacy, and adherence. RESULTS Results suggested that motivation is an important predictor of adherence to medication; moreover, higher self-efficacy was associated with higher motivation. Results also highlighted psychological distress as an important intervention target to improve medication adherence in emerging adults. CONCLUSIONS The model tested in this study may offer a feasible framework for beginning to understand adherence to controller medication in this population.
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Affiliation(s)
- Karen Kolmodin MacDonell
- Department of Behavioral Sciences and Social Medicine, Center for Translational Behavioral Science, College of Medicine, Florida State University, Tallahassee, FL, USA
| | | | | | | | - William Starbird
- College of Medicine, Central Michigan University, Mt Pleasant, MI, USA
| | - Amy Hall
- College of Nursing, Wayne State University, Detroit, MI, USA
| | - Rhonda Dailey
- School of Medicine, Wayne State University, Detroit, MI, USA
| | | | - Bo Wang
- Chan School of Medicine, University of Massachusetts, Worcester, MA, USA
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3
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Al-Noumani H, Alharrasi M, Lazarus ER, Panchatcharam SM. Factors predicting medication adherence among Omani patients with chronic diseases through a multicenter cross-sectional study. Sci Rep 2023; 13:7067. [PMID: 37127692 PMCID: PMC10151315 DOI: 10.1038/s41598-023-34393-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 04/28/2023] [Indexed: 05/03/2023] Open
Abstract
Management of chronic diseases is complex and requires a long-term commitment to therapeutic medications. However, medication adherence is suboptimal. There is limited understanding of factors predicting medication adherence in chronic diseases in Oman. This study aimed to examine predictors of medication adherence (i.e. patient clinical and demographic data, patient-physician relationship, health literacy, social support) among Omani patients with chronic diseases. This study used a cross-sectional correlation design. Data were collected from 800 participants using convenience sampling between December 2019 and April 2020. Arabic versions of the Brief Health Literacy Screening tool, Multidimensional Scale of Perceived Social Support, Patient-Doctor Relationship Questionnaire, and Adherence in Chronic Disease Scale were used to measure study variables. Descriptive statistics, independent t tests, one-way ANOVA, Pearson correlations, and multivariate linear regression were used for analysis. The study found that factors such as the patient-physician relationship, social support, disease duration, employment status, and medication frequency significantly predicted medication adherence. Medication adherence was higher among those who were unemployed, had a better patient-physician relationship, and greater social support. However, medication adherence was lower with longer disease duration and higher daily medication frequency. Additionally, medication adherence was positively associated with perceived social support and the patient-physician relationship, but not with health literacy. In conclusion, the study reveals that patient characteristics, social support, and patient-physician relationships are key factors in predicting medication adherence in patients with chronic diseases in the Middle East. It emphasizes the importance of improving these aspects, considering factors like employment status, disease duration, and medication frequency, and enhancing healthcare provider-patient relationships and social support systems to boost adherence.
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Affiliation(s)
- Huda Al-Noumani
- Adult Health and Critical Care Department, College of Nursing, Sultan Qaboos University, Muscat, Oman
| | - Maryam Alharrasi
- Adult Health and Critical Care Department, College of Nursing, Sultan Qaboos University, Muscat, Oman
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4
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Paracha R, Lo DKH, Montgomery U, Ryan L, Varakantam V, Gaillard EA. Asthma medication adherence and exacerbations and lung function in children managed in Leicester primary care. NPJ Prim Care Respir Med 2023; 33:12. [PMID: 36966170 PMCID: PMC10039953 DOI: 10.1038/s41533-022-00323-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 12/15/2022] [Indexed: 03/27/2023] Open
Abstract
Poor adherence to asthma preventer medication is associated with life-threatening asthma attacks. The quality and outcomes framework mandated primary care annual asthma review does not include adherence monitoring and the effect of poor adherence on lung function in paediatric primary care patients is unknown. The aim was to investigate the link between inhaled corticosteroid (ICS) adherence and spirometry, fraction of exhaled nitric oxide (FeNO) and asthma control in asthmatic school-age children in this cross-sectional observational study involving three Leicestershire general practices. Children 5-16 years on the practice's asthma registers, were invited for a routine annual asthma review between August 2018 and August 2019. Prescription and clinical data were extracted from practice databases. Spirometry, bronchodilator reversibility (BDR) and FeNO testing were performed as part of the review. 130 of 205 eligible children (63.4%) attended their review. Mean adherence to ICS was 36.2% (SEM 2.1%) and only 14.6% of children had good adherence (≥75% prescriptions issued). We found no differences in asthma exacerbations in the preceding 12 months between the adherence quartiles. 28.6% of children in the lowest and 5.6% in the highest adherence quartile had BDR ≥ 12% but this was not statistically significant (p = 0.55). A single high FeNO value did not predict adherence to ICS. Adherence to ICS in children with asthma in primary care is poor. The link between adherence to ICS and asthma exacerbations, spirometry and FeNO is complex but knowledge of adherence to ICS is critical in the management of children with asthma.
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Affiliation(s)
- Razi Paracha
- University Hospitals of Leicester NHS Trust, Leicester, UK.
| | - David K H Lo
- Department of Paediatric Respiratory Medicine, University Hospitals of Leicester NHS Trust., Leicester, UK
- Department of Respiratory Sciences, College of Life Sciences, NIHR Biomedical Research Centre (Respiratory theme), University of Leicester, Leicester, UK
| | | | | | | | - Erol A Gaillard
- Department of Paediatric Respiratory Medicine, University Hospitals of Leicester NHS Trust., Leicester, UK
- Department of Respiratory Sciences, College of Life Sciences, NIHR Biomedical Research Centre (Respiratory theme), University of Leicester, Leicester, UK
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5
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Tosca MA, Pistorio A, Silvestri M, Marseglia GL, Ciprandi G. The comparison between children and adolescents with asthma provided by the real-world "ControL'Asma" study. J Asthma 2021; 59:1531-1536. [PMID: 34112042 DOI: 10.1080/02770903.2021.1941089] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Because asthma is a disease that changes over time, the Italian Society of Pediatric Allergy and Immunology launched a nationwide study on asthma control (the ControL'Asma study). The intent was to test the hypothesis that children with asthma could present a different pattern compared to adolescents. In the study, we compared children with adolescents in a real-world setting by analyzing the asthma control grade and other asthma-related parameters. METHODS This cross-sectional real-world study included 471 asthmatic children (<age 12) and adolescents (≥age 12), mostly male (n = 326; 69.2%), who were consecutively enrolled at 10 tertiary pediatric allergy clinics. Asthma control level was evaluated according to the Global Initiative for Asthma (GINA) guidelines, the Childhood Asthma Control Test (cACT) questionnaire for children, and the Asthma Control Test (ACT) questionnaire for adolescents, history, rhinitis comorbidity, allergy, clinical examination, lung function, and perception of asthma symptoms assessed by visual analogue scale (VAS). RESULTS There was no difference between the age groups in asthma control as determined by both GINA criteria and the cACT/ACT questionnaires. However, adolescents with asthma had significantly more frequent rhinitis comorbidity (p = 0.02; OR = 2.07) and allergy (p = 0.012; OR = 3.72) than children. Asthma severity, lung function, and symptom perception were not different between age groups. CONCLUSIONS The current study showed that asthma control is not associated with age in young people. Adolescents with asthma did experience rhinitis and allergy more frequently than children. These findings reflect the progressive nature of the allergic phenotype in young patients.
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Affiliation(s)
- Maria Angela Tosca
- Allergy Center, Department of Pediatrics, Istituto Giannina Gaslini, Genoa, Italy
| | - Angela Pistorio
- Epidemiology, Biostatistics and Committe, Department of Direction, Istituto Giannina Gaslini, Genoa, Italy
| | - Michela Silvestri
- Allergy Center, Department of Pediatrics, Istituto Giannina Gaslini, Genoa, Italy
| | - Gian Luigi Marseglia
- Pediatrics Clinic, Pediatrics Department, Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - Giorgio Ciprandi
- Allergy Clinic, Department of Outpatients, Casa di Cura Villa Montallegro, Genoa, Italy
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6
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Federico MJ, Denlinger LC, Corren J, Szefler SJ, Fuhlbrigge AL. Exacerbation-Prone Asthma: A Biological Phenotype or a Social Construct. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2021; 9:2627-2634. [PMID: 34051392 DOI: 10.1016/j.jaip.2021.05.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 05/17/2021] [Accepted: 05/19/2021] [Indexed: 12/14/2022]
Abstract
Asthma is a complex syndrome with multiple phenotypes and endotypes. Asthma exacerbations are not only the clearest indictor of the morbidity of asthma and of the risk for mortality due to asthma, but also comprise a significant amount of the cost to care for poorly controlled asthma. There continues to be significant disparity in the prevalence, mortality, and morbidity due to asthma. Patients with asthma who suffer recurrent exacerbations are considered to have exacerbation-prone asthma (EPA). Efforts to characterize patients with frequent exacerbations show that the etiology is likely multifactorial. Research to determine the intrinsic risk factors for EPA include studies of both genetic and inflammatory biomarkers. External factors contributing to exacerbations have been extensively reviewed and include viral infection, environmental exposures, air pollution, and psychosocial and economic barriers to optimizing health. It is likely that EPA occurs when patients who have an increased underlying intrinsic/biological risk are placed in a given exposome (environments with a variety of exposures and triggers including allergens, pollution, stress, barriers, and occupational exposures). It is the social construct combined with underlying biology that frequently drives an EPA phenotype.
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Affiliation(s)
- Monica J Federico
- The Breathing Institute, Children's Hospital Colorado, and Department of Pediatrics, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, Colo.
| | - Loren C Denlinger
- Division of Allergy, Pulmonary, and Critical Care Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wis
| | - Jonathan Corren
- Departments of Medicine and Pediatrics, Divisions of Allergy and Clinical Immunology, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, Calif
| | - Stanley J Szefler
- The Breathing Institute, Children's Hospital Colorado, and Department of Pediatrics, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, Colo
| | - Anne L Fuhlbrigge
- Pulmonary Sciences and Critical Care, Department of Medicine, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, Colo
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Caminati M, Vaia R, Furci F, Guarnieri G, Senna G. Uncontrolled Asthma: Unmet Needs in the Management of Patients. J Asthma Allergy 2021; 14:457-466. [PMID: 33976555 PMCID: PMC8104981 DOI: 10.2147/jaa.s260604] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 04/05/2021] [Indexed: 12/14/2022] Open
Abstract
The recent scientific research has provided clinicians with the tools for substantially upgrading the standard of care in the field of bronchial asthma. Nevertheless, satisfactory asthma control still remains an unmet need worldwide. Identifying the major determinants of poor control in different asthma severity levels represents the first step towards the improvement of the overall patients' management. The present review aims to provide an overview of the main unmet needs in asthma control and of the potential tools for overcoming the issue. Implementing a personalized medicine approach is essential, not only in terms of pharmacological treatments, biologic drugs or sophisticated biomarkers. In fact, exploring the complex profile of each patient, from his inflammation phenotype to his preferences and expectations, may help in filling the gap between the big potential of currently available treatments and the overall unsatisfactory asthma control. Telemedicine and e-health technologies may provide a strategy to both optimize disease assessment on a regular basis and enhance patients' empowerment in managing their asthma. Increasing patients' awareness as well as the physicians' knowledge about asthma phenotypes and treatment options besides corticosteroid probably represent the key and more difficult goals of all the players involved in asthma management at every level.
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Affiliation(s)
- Marco Caminati
- Department of Medicine, University of Verona, Verona, Italy
| | - Rachele Vaia
- Department of Medicine, University of Verona, Verona, Italy
| | - Fabiana Furci
- Allergy Unit and Asthma Center, University of Verona and Verona University Hospital, Verona, Italy
| | - Gabriella Guarnieri
- Respiratory Pathophysiology Unit, Department of Cardiological, Thoracic and Vascular Sciences, University of Padua, Padua, Italy
| | - Gianenrico Senna
- Department of Medicine, University of Verona, Verona, Italy.,Allergy Unit and Asthma Center, University of Verona and Verona University Hospital, Verona, Italy
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8
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Psihogios AM, Li Y, Ahmed A, Huang J, Kersun LS, Schwartz LA, Barakat LP. Daily text message assessments of 6-mercaptopurine adherence and its proximal contexts in adolescents and young adults with leukemia: A pilot study. Pediatr Blood Cancer 2021; 68:e28767. [PMID: 33073479 DOI: 10.1002/pbc.28767] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 09/29/2020] [Accepted: 10/01/2020] [Indexed: 12/31/2022]
Abstract
BACKGROUND This pilot study explored the feasibility and acceptability of implementing text-based assessments of oral chemotherapy adherence in adolescents and young adults (AYA) with leukemia. METHODS AYA prescribed maintenance 6-mercaptopurine (6MP) received daily text message surveys and utilized an electronic pill bottle for 28 days. Text surveys assessed 6MP adherence and contextual associates (eg, mood). Feasibility was defined by recruitment/retention rates, survey completion rates, cost, and technical issues. After the 28-day period, AYA completed an acceptability survey. Secondary analyses compared text survey and electronic pill bottle adherence rates, and explored the daily associations between contextual factors and 6MP nonadherence. RESULTS Eighteen AYA enrolled (M age = 18, range 15-22) and completed study procedures (100% recruitment and retention rates). Adherence survey completion rates were high (M = 88.9%), the technology cost was $204.00, and there were few technical issues. AYA reported high satisfaction with the surveys and perceived them as a helpful medication reminder. While not significantly correlated, survey and electronic pill bottle adherence data converged on the majority of days (>90%). Exploratory analyses showed that AYA were more likely to miss a dose of 6MP on weekends (OR = 2.33, P = .048) and on days when their adherence motivation (OR = 0.28, P = .047) and negative affect (OR = 3.92, P = .02) worsened from their own typical functioning. CONCLUSIONS For AYA with leukemia, daily text-based surveys are a feasible and acceptable method for delivering medication adherence assessments, and may operate as a short-term intervention. To develop personalized mobile health interventions, findings also highlighted the need to study time-varying predictors of 6MP nonadherence.
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Affiliation(s)
- Alexandra M Psihogios
- The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.,University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Yimei Li
- The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.,University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Annisa Ahmed
- The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Jing Huang
- The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.,University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Leslie S Kersun
- The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.,University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Lisa A Schwartz
- The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.,University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Lamia P Barakat
- The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.,University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
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9
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Tosca MA, Licari A, Pistorio A, Marseglia GL, Ciprandi G. ControL'Asma Project: new insights. Pediatr Allergy Immunol 2020; 31 Suppl 26:23-25. [PMID: 33236422 DOI: 10.1111/pai.13353] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 08/04/2020] [Indexed: 12/13/2022]
Abstract
The Italian Society of Paediatric Allergy and Immunology has developed the project "ControL'Asma," a nationwide study involved ten third-level pediatric allergy clinics across Italy. The first findings of the "ControL'Asma" project showed that asthma was more frequent in males, had an early onset and allergic phenotype with very frequent rhinitis comorbidity, uncontrolled, and partly controlled asthma affected about the half of subjects, and the assessment of asthma symptom perception by VAS could be a reliable tool in the asthma management.
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Affiliation(s)
| | - Amelia Licari
- Pediatric Clinic, Department of Pediatrics, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - Angela Pistorio
- Epidemiology, Biostatistics and Committees Unit, Istituto Giannina Gaslini, Genoa, Italy
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10
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Licari A, Ciprandi G, Marseglia GL, Silvestri M, Tosca MA, Anastasio E, Brambilla I, Caffarelli C, Castagnoli R, Chini L, Ciprandi R, De Vittori V, Duse M, Di Cicco ME, Indinnimeo L, Kantar A, Leone M, Marinelli G, Moschese V, Olcese R, Peroni DG, Pistorio A, Salmaso C, Zicari AM. Asthma in children and adolescents: the ControL'Asma project. ACTA BIO-MEDICA : ATENEI PARMENSIS 2020; 91:e2020002. [PMID: 33004772 PMCID: PMC8023065 DOI: 10.23750/abm.v91i11-s.10295] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 07/21/2020] [Indexed: 11/23/2022]
Abstract
The control of asthma is the objective of asthma management. However, it is difficult to obtain in clinical practice. The Italian Society of Allergy and Clinical Immunology promoted the nationwide project "ControL'Asma" to investigate the real situation in a group of children and adolescents with asthma. The preliminary outcomes demonstrated that many asthmatic subjects do not achieve adequate asthma control. Moreover, asthma in Italian children and adolescents was usually more frequent in males, had an early onset and allergic phenotype with very frequent rhinitis comorbidity, uncontrolled and partly controlled asthma affected about the half of subjects. However, this project suggested that the assessment of asthma symptom perception by VAS could be a reliable tool in the asthma management.
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Affiliation(s)
- Amelia Licari
- Pediatric Clinic, Department of Pediatrics, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy.
| | - Giorgio Ciprandi
- Department of Medicine, Allergy Clinic, Casa di Cura Villa Montallegro, Genoa, Italy.
| | - Gian Luigi Marseglia
- Pediatric Clinic Department of Pediatrics, Fondazione IRCCS Policlinico S. Matteo, University of Pavia, Pavia, Italy.
| | | | | | - Elisa Anastasio
- Department of Medical and Surgical Sciences, Pediatrics Unit, University"Magna Graecia", Catanzaro, Italy; “ControL’Asma” Study Group.
| | - Ilaria Brambilla
- Pediatric Clinic, Department of Pediatrics, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy; “ControL’Asma” Study Group.
| | - Carlo Caffarelli
- Pediatric Clinic, Department of Medicine and Surgery, University of Parma, Parma, Italy; “ControL’Asma” Study Group.
| | - Riccardo Castagnoli
- Pediatric Clinic, Department of Pediatrics, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy; “ControL’Asma” Study Group.
| | - Loredana Chini
- Paediatric Immunopathology and Allergology Unit, Tor Vergata University Hospital, University of Roma Tor Vergata, Rome, Italy; “ControL’Asma” Study Group.
| | - Riccardo Ciprandi
- Cystic Fibrosis Center, IRCCS Istituto Giannina Gaslini-Ospedale Pediatrico, Genoa, Italy; “ControL’Asma” Study Group.
| | - Valentina De Vittori
- Department of Pediatrics, Sapienza University of Rome, Rome, Italy; “ControL’Asma” Study Group.
| | - Marzia Duse
- Department of Pediatrics, Sapienza University of Rome, Rome, Italy; “ControL’Asma” Study Group.
| | - Maria Elisa Di Cicco
- Pediatric Division, Department of Obstetrics, Gynecology and Pediatrics, St. Chiara University Hospital, Pisa, Italy; “ControL’Asma” Study Group.
| | - Luciana Indinnimeo
- Department of Pediatrics and NPI, University of Roma Sapienza, Rome, Italy; “ControL’Asma” Study Group.
| | - Ahmad Kantar
- Pediatric Cough and Asthma Center, Istituti Ospedalieri Bergamaschi, University and Research Hospitals, Bergamo, Italy; “ControL’Asma” Study Group.
| | - Maddalena Leone
- Maternal and Infantile Department of Pediatrics ASST Grande Ospedale Metropolitano Niguarda Milano, Italy; “ControL’Asma” Study Group.
| | - Guido Marinelli
- Pediatria, Università di Genova; “ControL’Asma” Study Group.
| | - Viviana Moschese
- Pediatric Allergology and Immunology Unit, University of Rome Tor Vergata, Policlinico Tor Vergata, Rome, Italy; “ControL’Asma” Study Group.
| | - Roberta Olcese
- Pediatric Allergy Center, Istituto Giannina Gaslini, Genoa, Italy; “ControL’Asma” Study Group.
| | - Diego G Peroni
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy; “ControL’Asma” Study Group.
| | - Angela Pistorio
- IRCCS Istituto Giannina Gaslini, Genoa, Italy; “ControL’Asma” Study Group.
| | - Claudia Salmaso
- Pediatric Allergy Center, Istituto Giannina Gaslini, Genoa, Italy; “ControL’Asma” Study Group.
| | - Anna Maria Zicari
- Department of Pediatrics, Policlinico Umberto I, Sapienza University, Rome, Italy; “ControL’Asma” Study Group.
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11
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Federico MJ, McFarlane AE, Szefler SJ, Abrams EM. The Impact of Social Determinants of Health on Children with Asthma. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2020; 8:1808-1814. [PMID: 32294541 DOI: 10.1016/j.jaip.2020.03.028] [Citation(s) in RCA: 79] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 03/12/2020] [Accepted: 03/25/2020] [Indexed: 12/20/2022]
Abstract
SzAsthma is the most common chronic disease of childhood. Disparities in asthma outcomes have led to international attention on the biologic, social, economic, and other factors that impact the health of children with asthma. Studies indicate that social determinants of health such as housing, neighborhood safety, and access to care significantly impact the health of children with asthma. However, screening for socioeconomic and environmental factors that impact asthma can be difficult to integrate into clinical practice. In addition, it is not yet clear which interventions to address these factors are most effective. This article will review recent studies of determinants and social determinants of health and propose a framework for identifying and addressing them in the care of children with asthma in a clinical setting.
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Affiliation(s)
- Monica J Federico
- The Breathing Institute and Pulmonary Medicine Section, Children's Hospital Colorado and University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, Colo
| | - Arthur E McFarlane
- The Breathing Institute and Pulmonary Medicine Section, Children's Hospital Colorado and University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, Colo
| | - Stanley J Szefler
- The Breathing Institute and Pulmonary Medicine Section, Children's Hospital Colorado and University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, Colo
| | - Elissa M Abrams
- Department of Pediatrics, Section of Allergy and Clinical Immunology, University of Manitoba, Winnipeg, MB, Canada; Department of Pediatrics, Division of Allergy and Immunology, University of British Columbia, Vancouver, BC, Canada.
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