Dataset Information

Home Medication Readiness for Preschool Children With Asthma.

ABSTRACT: BACKGROUND:Having a medication available in the home is a prerequisite to medication adherence. Our objectives with this study are to assess asthma medication readiness among low-income urban minority preschool-aged children, and the association between beliefs about medications and medication readiness. METHODS:During a baseline assessment, a research assistant visited the home to administer a caregiver survey and observe 5 criteria in the medication readiness index: the physical presence and expiration status of medications, the counter status of metered-dose inhalers, and caregiver knowledge of medication type and dosing instructions. RESULTS:Of 288 enrolled children (mean age 4.2 years [SD: 0.7], 92% African American, 60% boys), 277 (96%) of their caregivers reported a rescue medication, but only 79% had it in the home, and only 60% met all 5 of the medication readiness criteria. Among the 161 children prescribed a controller medication, only 79% had it in the home, and only 49% met all 5 readiness criteria. Fewer worries and concerns about medications were associated with higher odds of meeting all 5 readiness criteria for controller medications. CONCLUSIONS:Inadequate availability of asthma medications in the home is a barrier to adherence among low-income urban preschoolers. Assessment of medication readiness should be incorporated into clinical care because this is an underrecognized barrier to adherence, and interventions are needed to improve medication management and knowledge to increase adherence.

SUBMITTER: Callaghan-Koru JA

PROVIDER: S-EPMC6317646 | biostudies-literature | 2018 Sep

REPOSITORIES: biostudies-literature

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Home Medication Readiness for Preschool Children With Asthma.

Callaghan-Koru Jennifer A JA Riekert Kristin A KA Ruvalcaba Elizabeth E Rand Cynthia S CS Eakin Michelle N MN

Pediatrics 20180807 3

<h4>Background</h4>Having a medication available in the home is a prerequisite to medication adherence. Our objectives with this study are to assess asthma medication readiness among low-income urban minority preschool-aged children, and the association between beliefs about medications and medication readiness.<h4>Methods</h4>During a baseline assessment, a research assistant visited the home to administer a caregiver survey and observe 5 criteria in the medication readiness index: the physical ...[more]

PMID: 30087197

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Project description:ImportanceHome visiting programs targeting the school readiness of preschool children (age range, 4-5 years) show promise in short-term and quasi-experimental studies but rarely are evaluated with rigorous designs and follow-up assessments.ObjectivesTo examine the sustained effects of a preschool home visiting program on child and family competencies and on child need for services 4 years later.Design, setting, and participantsIn a randomized clinical trial, individual families with preschool children were assigned to receive the Research-Based and Developmentally Informed-Parent home visiting program (REDI-P) (intervention group) or math home learning games in the mail (control group). Follow-up assessments occurred in third grade. Families were recruited from 24 Head Start centers in 3 Pennsylvania counties serving rural and urban areas. Four-year-old children from 200 low-income families participated. Families were recruited in fall 2008 and fall 2009. The follow-up data used were collected in spring 2013 and spring 2014. The analyses were conducted in 2016 to 2017.InterventionsREDI-P visits followed a well-specified curriculum, with 10 home visits during preschool and 6 booster visits in kindergarten. Parents received coaching to enhance parent-child relationships and home learning materials to support child development and school readiness.Main outcomes and measuresIntervention focused on boosting competencies in academic performance and social-emotional adjustment and reducing child problems at home. Direct assessments, teacher ratings, and parent reports were collected. In addition, third-grade teachers recorded all services that children needed and received at school.ResultsTwo hundred participating children (110 [55.0%] white, 52 [26.0%] black, and 38 [19.0%] Latino; 112 [56.0%] male) had a mean (SD) age of 4.45 (0.29) years at the start of intervention. Third-grade outcomes were available for 153 (76.5%) of the initial sample and revealed statistically significant effects on multiple measures in each competency domain. In addition, REDI-P reduced child need for educational and mental health services at school. Significant effect sizes were small to moderate, averaging approximately one-third of 1 SD (Cohen d = 0.27 to 0.45). Mediation models demonstrated that intervention effects on services were accounted for by intervention effects on the targeted competencies.Conclusions and relevanceREDI-P produced sustained benefits evident 4 years after intervention, significantly reducing child need for school services. The results of this study appear to validate the value of preschool home visiting as a strategy to help close the gap in school readiness and child well-being associated with poverty.

Dataset Information

Home Medication Readiness for Preschool Children With Asthma.

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Home Medication Readiness for Preschool Children With Asthma.

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