Barriers to anti-inflammatory medication use in childhood asthma

Ambul Pediatr. 2003 Jul-Aug;3(4):181-90. doi: 10.1367/1539-4409(2003)003<0181:btamui>;2.


Objectives: To identify parental barriers to anti-inflammatory medication use and to develop an instrument for use in research and health care settings to identify at-risk populations.

Methods: Instrument development consisted of 4 phases: 1) gaining the professional perspective (N = 8 experts in asthma management), 2) gaining the perspective of parents of children with asthma (qualitative interviews with 21 parents), 3) instrument pretesting and refinement (N = 133 parents), and 4) determining the instrument's psychometric properties. Study participants were diverse in race, socioeconomic status, and the child's illness severity. The final instrument consisted of 51 questions in 5 domains (nature of disease, cause, ideas about medications, treatment expectations, and health care provider relationship).

Results: The final instrument exhibited strong reliability (Cronbach alpha =.87) and validity. Significant barriers to appropriate anti-inflammatory medication use were parents' diminished treatment expectations and fears about anti-inflammatory medications. Minority families were more likely than white families to view asthma as unpredictable and uncontrollable (P =.01) and to have negative attitudes toward anti-inflammatory medications (P =.004). Eight questions were significantly correlated with a suboptimal medication regimen and may serve as a "quick screen" for potential nonadherence in clinical settings.

Conclusions: Diminished treatment expectations and negative attitudes toward anti-inflammatories may be powerful predictors of nonadherence to medications.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.
  • Validation Study

MeSH terms

  • Adolescent
  • Adult
  • Anti-Inflammatory Agents / adverse effects
  • Anti-Inflammatory Agents / therapeutic use*
  • Asthma / drug therapy*
  • Attitude to Health*
  • Black or African American / education
  • Black or African American / psychology
  • Child
  • Child, Preschool
  • Drug Utilization
  • Fear
  • Female
  • Health Knowledge, Attitudes, Practice
  • Health Services Accessibility / standards*
  • Health Services Research
  • Humans
  • Male
  • New York
  • Parents / education*
  • Parents / psychology*
  • Psychometrics
  • Qualitative Research
  • Risk Factors
  • Socioeconomic Factors
  • Steroids
  • Surveys and Questionnaires / standards*
  • White People / education
  • White People / psychology


  • Anti-Inflammatory Agents
  • Steroids