Exploring the intersection of executive function and medication adherence in school-age children with asthma

ABSTRACT

Asthma is one of the most common chronic diseases of childhood. For children with persistent asthma, asthma control is largely related to controller medication adherence. With increasing calls for children to be involved in their own asthma management, there is a gap in our knowledge about the executive functioning of children with asthma. Objective: The purpose of this study was to explore the relationship between executive function, asthma, and medication adherence among school-age children with asthma. Methods: Thirty-one children ages 7 to 11 years (M = 8.9 ± 1.51) and one of their parents were enrolled in this study. Parents reported on asthma control while children reported on asthma control, medication beliefs, medication adherence, and completed an executive function battery that assessed inhibition, updating, shifting and planning. Results: Compared to the reference sample, children in this study had significantly lower composite scores in inhibition, t (31) = −3.84, p =. 001, and shifting, t (30) = −3.73, p =. 001. Controlling for age and asthma control, hierarchical regression analyses revealed that shifting accounted for 16% of the variance in child-reported medication adherence. Conclusions: This study revealed lowered executive functioning scores among school-age children with persistent asthma. Furthermore, it appears executive functioning and controller medication adherence are intertwined and warrant future exploration.

KEYWORDS:

• Shared management
• cognitive function
• self-regulation
• controller medication
• inhibition
• updating
• shifting

Acknowledgements

The authors gratefully acknowledge Drs. Ki Moore, Lynn Gerald, and Chris Segrin for their assistance with the study design, implementation, and analysis; Dr. Jamie Goodwin and Argelia Benavides of the Arizona Respiratory Center for their assistance with recruitment; Ms. Rachelle Begay for her assistance with recruitment and data collection; and Ms. Kari Koerner Marano for her expertise and assistance with data collection.

Declaration of Interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.