Each 1% increase in out-of-pocket money spent on asthma drugs linked to 14% increase in exacerbations

Less than 25% of asthmatic children are well controlled. This retrospective study of 490 children from Canada attempted to identify factors associated with asthma exacerbation related to health status, socioeconomic status (SES), and drug insurance.

Factors associated with asthma exacerbations:

- younger age
- previous emergency visits
- nebulizer use
- pet ownership
- receipt of asthma education but not an action plan
- food, drug, or insect allergies

Children with high income adequacy had 28% fewer exacerbations than did children with low income adequacy.

In the subgroup with drug insurance, girls had 26% fewer exacerbations than did boys. Children with food, drug, or insect allergies had 52% more exacerbations than did children without allergies.

Every percentage increase in the proportion of income spent out-of-pocket on asthma medications was associated with a 14% increase in exacerbations.

The diagram above shows the cost of different asthma Inhalers (click to enlarge the image).


Relationship of asthma management, socioeconomic status, and medication insurance characteristics to exacerbation frequency in children with asthma. Ungar WJ, Paterson JM, Gomes T, Bikangaga P, Gold M, To T, Kozyrskyj AL. Ann Allergy Asthma Immunol. 2011 Jan;106(1):17-23.

Shift-and-persist strategy (reframing stressors positively, optimism) protects low-SES children with asthma. JACI, 2011.

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