Problem: Asthma affects one out of every ten children in the United States. It is recommended that children with persistent asthma take long-term controller (LTC) medications to achieve control. However, adherence varies, and many children do not take their LTC medication at all. The average cost for hospitalization of a child with asthma is $8,406. Asthma in children also contributes to school absenteeism and a decrease in quality of life. Objective: A literature review was performed to examine factors that affect adherence to LTC medications used to control asthma in children. Method: A literature review was performed using the CINAHL, ERIC, Medline, Psych Info, and Academic Search Premier databases. Keywords included asthma AND child* OR pediatric* AND adherence OR compliance AND corticosteroid* OR “leukotriene modifier*” OR “mast cell stabilizer*” OR “monoclonal antibod*” OR “long-acting beta agonist.*” After applying exclusion criteria 35 articles were included in this review. Results: A variety of factors that affect adherence were identified. Internal factors included age, sex, and race/ethnicity. External factors included socioeconomic status, environment, health perception, lack of motivation, parental education, disease/medication beliefs, family dynamics and planning, responsibility, severity, and exacerbations. Interventional factors included caregiver-family communication, asthma knowledge, specialty care, white coat adherence, number of prescriptions, asthma action plans, medication regimens, and technology. Conclusion: It is recommended that healthcare providers use a four-step process during inpatient and outpatient asthma visits. The steps include assess and educate, collaborate, problem-solve, and follow-up. Collectively, this method can help healthcare providers overcome many of the barriers that were identified.

Asthma is the most common chronic disease of childhood. Children diagnosed with asthma are twice as likely to have a comorbid anxiety disorder as their non-asthmatic peers. The presence of both asthma and anxiety in the pediatric patient creates an environment of poor asthma control, and places them at risk for a variety of negative health events. Little is known about comorbid anxiety’s role in asthma health maintenance. Research has identified the link between these two conditions but causation is difficult to conclude. The aim of this thesis is to assess the current state of the science regarding pediatric asthma and anxiety. This integrated review of the literature will identify the factors contributing to the vicious cycle of pediatric anxiety and asthma. Recommendations for practice and future research will be made.

Inaccurate dosing of children’s liquid medication is a major problem that causes adverse effects for children every year. In order to prevent these errors, education for at risk parents is essential. A survey and observational study was done in order to identify parents/caregivers who make dosing errors when measuring out liquid medication for their children. A total of 25 parents/caregivers with children admitted to Arnold Palmer Hospital were included in this study. Study participants completed a survey that included demographic data as well as parenting experience. The parents were directly observed measuring a dose of corn syrup using Children’s liquid Tylenol® dosing instructions. The research participants were offered a variety of common measuring devices and they chose the one they most often used at home. Data indicated a high incidence of dosing errors made by a variety of participants. Of the 25 research participants, 13 (52%) made an error greater than 20% when measuring out the dose based on the provided instructions and their child’s weight. This data suggests nurses need to include dosing education for all parents at discharge. This study has shown that many parents are at risk for making errors when measuring medication. Effective discharge education on the importance of measuring medication accurately can prevent these errors and the adverse effects they cause.

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Thesis (M.S.)--Boston University / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / 2999-01-01