Underuse of Controller Medications Among Medicaid-Insured Children With Asthma

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Abstract
Results: The response rate was 66%, with 1648 children included in the analysis; 1083 were classified as having per- sistent asthma. Of these, 73% were underusers of control- ler therapy, with 49% reporting no controller use and 24% reporting less than daily use. A multivariate model that ad- justed for age, managed health care organization, and AAP Physical Function Score found that black (odds ratio (OR), 1.7; 95% confidence interval (CI), 1.2-2.4) or Latino (OR, 2.2; 95% CI, 1.3-3.8) race were associated with underuse and that parental education beyond high school was pro- tective (OR, 0.6; 95% CI, 0.4-0.8). Having a primary care physician(OR,0.4;95%CI,0.2-0.8),writtenactionplan(OR, 0.5; 95% CI, 0.4-0.7), or a follow-up visit (OR, 0.5; 95% CI, 0.4-0.8) and having seen an asthma specialist (OR, 0.5; 95% CI, 0.4-0.7) were associated with lower rates of underuse. Conclusions: Underuse of controller medications among Medicaid-insured children is widespread. Racial minori- ties and children whose parents are less educated are at higher risk for underuse. Patients who have received ac- tion plans or had follow-up visits or specialty consulta- tions are less likely to be symptomatic underusers of con- troller medications. Arch Pediatr Adolesc Med. 2002;156:562-567