Oral β₂-Agonist Use by Preschool Children with Asthma in East and Central Harlem, New York

Abstract

Although studies have documented underuse of controller medications and overuse of short-acting inhaled β₂-agonist among children with persistent asthma in disadvantaged communities, the persistence of oral β₂-agonist use in pediatric practice has not been studied since inhaled short-acting β₂-agonists became widespread. We describe medications used to treat asthma among children 3 to 5 years of age at 10 Head Start and other subsidized preschool centers in East and Central Harlem, New York City. We interviewed 149 parents/guardians of children who were identified as having probable asthma based on physician's diagnosis, persistent symptoms, hospitalization, and medication use. We classified 86 of the 149 children (58%) as having current persistent asthma. Only 15 of them (17%) were reported to have used controller medications at least 5 days/week in the last 4 weeks—only 2 of whom used inhaled corticosteroids. By contrast, 53 children (62%) used oral β₂-agonist in the last 4 weeks, often (72%) in conjunction with nebulized or inhaled short-acting β₂-agonist. Use of oral β₂-agonist was associated with more severe symptoms. This study documents the continued widespread use of oral β₂-agonist for treatment of children in a low-income community with high prevalence of asthma.

Keywords:

• asthma
• pediatrics
• adrenergic beta-agonists
• minority groups
• Head Start program