Socioeconomic status and medication prescription patterns in pediatric asthma in Canada

J Adolesc Health. 2006 May;38(5):607.e9-16. doi: 10.1016/j.jadohealth.2005.02.010.


Purpose: To investigate whether the socioeconomic status of children and adolescents with asthma is associated with optimal use of asthma medications in a health care system that provides free access to prescribed medications.

Methods: A cohort of 29,018 children (5-12 y) and adolescents (13-17 y) with asthma was reconstructed from the administrative health database of the Régie de l'assurance maladie du Québec in Canada. Adherence to the Canadian Asthma Guidelines was compared between low-income patients (patients living in families receiving social assistance) and higher-income patients (patients living in middle-class families with working parents). Both groups of patients had free, universal access to medical care and prescribed medications. Patients were considered adherent if they had: (1) 10 doses or fewer of a short-acting beta2-agonist (SABA) per week or (2) greater than 10 doses of a SABA per week plus greater than 1,000 microg of beclomethasone chlorofluorocarbon (CFC) per day. A second definition of adherence was used in which the 10 doses of SABA were replaced by 3 doses.

Results: Our cohort comprised 7,454 adolescents and 21,564 children. Within each definition, low-income adolescents had similar rates of adherence as higher-income adolescents (p = .08-.4). Low-income children, however, had lower rates of adherence than higher-income children when the first definition of adherence was used (76% vs. 80%; p < .001).

Conclusion: Our study showed that socioeconomic status had a small influence on the likelihood of receiving treatment in adherence with the Canadian Asthma Guidelines among children, whereas no association was detected among adolescents.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Anti-Asthmatic Agents / therapeutic use*
  • Asthma / drug therapy*
  • Asthma / economics
  • Canada
  • Child
  • Child, Preschool
  • Cohort Studies
  • Drug Prescriptions / statistics & numerical data*
  • Female
  • Guideline Adherence
  • Humans
  • Income
  • Male
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Social Class*


  • Anti-Asthmatic Agents