What Really Happens in the Home: The Medication Environment of Urban, Minority Youth.
BACKGROUND
Asthma disproportionately affects minority youth. Understanding the home medication environment and its relation to medication adherence can shape interventions to improve health outcomes.


OBJECTIVE
The objective of this study was to describe the asthma medication environment in the homes of urban minority youth and to determine predictors of medication use and technique in this population.


METHODS
Baseline data from 2 cohorts of minority youth with asthma in Chicago were combined for cross-sectional analysis. Bilingual research assistants (RAs) collected data in the home. RAs asked caregivers and children to self-report medications using pictures and observed children's asthma medications and inhaler technique.


RESULTS
The sample contained 175 mainly Latino youth (85.6%) ranging from 5 to 18 years old. Most were on public insurance (80%) and had uncontrolled asthma by self-report (89.7%). Only 27.4% had a spacer, 74.9% had a quick relief medicine, and 48.6% had any controller medicine. RA observations of controllers agreed with children (36%) and parental self-report (42.3%) but did not match the specific observed controllers. Children reported less parental help with medications (43%) than their parents (58.1%). One child was able to properly demonstrate 100% of the inhaler steps and 35.6% achieved >70% of inhaler steps. A better medication technique was associated with having a controller (b = 12.2, SE = 3.0, P < .0001), quick reliever (b = 8.05, SE = 3.5, P = .023), and a spacer (b = 9.3, SE = 3.54, P = .009).


CONCLUSIONS
This rigorous evaluation of the home medication environment of high-risk youth demonstrated that many families lack critical medications, devices, and a technique for proper management of asthma.
['Pappalardo|Andrea A|AA|', 'Karavolos|Kelly|K|', 'Martin|Molly A|MA|']
D000293:Adolescent D001249:Asthma D002648:Child D002675:Child, Preschool D015331:Cohort Studies D003430:Cross-Sectional Studies D017723:Drug Utilization Review D005260:Female D006630:Hispanic or Latino D006801:Humans D008297:Male D055118:Medication Adherence D008913:Minority Groups D054525:Minority Health D019303:Multilingualism D058996:Quality Improvement D012648:Self Care D057566:Self Report D014481:United States D014505:Urban Population
Asthma Inhaler technique Latino Cultural competency Health disparities Pediatric Puerto Rican