June 1, 1998 DENVER- Children who don't take prescribed medication are more likely to be found in families where affection isn't displayed, and where expectations and consequences of behavior aren't expressed to the child, according to National Jewish Medical and Research Center researchers.
"When you look at people who fail in the treatment of asthma you find a higher number of families and kids with psychological problems" said Bruce Bender, Ph.D., head of Neuropsychology at National Jewish Medical and Research Center. But, he adds, "a child who doesn't take his or her medications doesn't necessarily have psychological problems."
The study, by Bender and National Jewish's Henry Milgrom, M.D., is published in the June issue of the Journal of Asthma.
"Medication adherence was linked to the emotional climate and level of organization within the family," according to the article. Using a standardized questionnaire, families that agreed with the following statements --"We are reluctant to show our affection for each other;" "Some of us just don't respond emotionally"-- were more likely to have a child with asthma who did not follow a physician's instructions for medication use.
Regular family fights and disorganization are among the problems experienced in families whose children have difficulty following treatment instructions given by a physician. "A real red flag is conflict in the family," Bender said.
General family disorganization can be another indicator of the type of family situation that lends itself to problems for a child with asthma. "Things get lost in the hub-bub and stress of everyday life," he said. A pattern of disorganization in the family can have severe consequences for a child with asthma because the disease takes a tremendous amount of work to control.
The study also found that knowledge of asthma's symptoms and treatments alone is not enough to ensure that a child will take medication as prescribed. For example, parents reported that they understood a physician's instructions, but often failed to follow them. But the more information the parent and child have about asthma, the more likely the child is to take his or her medication, according to the study.
National Jewish researchers followed 24, 6-12 year olds with asthma for three months. During that time, parents monitored their child's medication use with a hand-written diary. In addition, a small computer, which records the date and time the drug is taken, was embedded into all asthma inhalers.
Failure to follow physician instruction while being treated for asthma can lead to multiple emergency room visits, more frequent doctor visits, and days missed from school or work. About 15 million people in the United States have asthma. Of that number, 4.8 million are under 18.
For information about asthma, call LUNG LINE, (800) 222-LUNG.
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