Counseling and Asthma Medication Usage in Latino Children
Asthma outcomes often are less-than-optimal in ethnic minority children when compared to non-Latino white (NLW) children, but those from Caribbean areas, such as Puerto Rico, fare even worse. With a lifetime prevalence rate of asthma of 26% compared to 13% in NLW, Puerto Rican children also have twice the rate of exacerbations—12% compared to 6%.
A new study
published in the journal Pediatrics suggests that lack of medication adherence is one of the biggest contributors to the problem. The authors recommend ways that frontline providers, such as pharmacists, can help.
The study sample included 277 children, who had been prescribed objectively monitored controller medications. The sample was divided into three groups—80 were island Puerto Ricans, 114 were Latinos living in Rhode Island and 83 were non-Latino whites living in Rhode Island.
The children's families completed questionnaires about family background and beliefs about medication, and they also were interviewed.
For each of the medications, Fluticasone, combination diskus, and Montelukast, the highest rates of adherence were among the non-Latino white children, with the others much lower. "Our data have important clinical implications given the central role of medications in decreasing asthma morbidity," study authors note.
Addressing cultural beliefs may be necessary to increase use of controller medications for asthma, they suggest. In fact, the authors urge health care providers such as pharmacists to "assume that many families will have difficulties in using controller medications as consistently as directed."
One approach would be to help the family fit medication usage into their family structure and schedule, according to the authors, with the other focusing on allaying parental concerns about the medications.
"Specifically, health care providers could engage parents in a brief discussion regarding their beliefs and concerns about medication use and provide them with information about medication benefits," the authors suggested. "Culturally tailored approaches that address parental concerns have been shown to be effective for Latino families of children with asthma."