The Relationship Between Pediatric Attention-Deficit/Hyperactivity Disorder Symptoms and Asthma Management

Authors

Gabriella D. Silverstein, Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, New York.
Kimberly Arcoleo, College of Nursing, University of Rhode Island, Providence, Rhode Island.
Deepa Rastogi, Children's National Hospital, George Washington University School of Medicine and Health Sciences, Washington, D.C.
Denise Serebrisky, Jacobi Medical Center, Pulmonology Division, Bronx, New York.
Karen Warman, Division of General Academic Pediatrics, Department of Pediatrics, Albert Einstein College of Medicine/The Children's Hospital at Montefiore, Bronx, New York.
Jonathan M. Feldman, Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, New York; Division of General Academic Pediatrics, Department of Pediatrics, Albert Einstein College of Medicine/The Children's Hospital at Montefiore, Bronx, New York. Electronic address: jonathan.feldman@yu.edu.

Document Type

Journal Article

Publication Date

11-1-2023

Journal

The Journal of adolescent health : official publication of the Society for Adolescent Medicine

Volume

73

Issue

5

DOI

10.1016/j.jadohealth.2023.02.028

Keywords

ADHD; Asthma; Medication adherence; Minority groups

Abstract

PURPOSE: Children with comorbid Attention-Deficit/Hyperactivity Disorder (ADHD) and asthma are at an increased risk for adverse health outcomes and reduced quality of life. The objective of these analyses was to examine if self-reported ADHD symptoms in children with asthma are associated with asthma control, asthma controller medication adherence, quick relief medication use, pulmonary function, and acute healthcare utilization. METHODS: We analyzed data from a larger study testing a behavioral intervention for Black and Latinx children with asthma aged 10-17 years and their caregivers. Participants completed the Conners-3AI self-report assessment for ADHD symptoms. Asthma medication usage data were collected for 3 weeks following baseline via electronic devices fitted to participants' asthma medications. Other outcome measures included the Asthma Control Test, self-reported healthcare utilization, and pulmonary function measured by spirometry testing. RESULTS: The study sample consisted of 302 pediatric participants with an average age of 12.8 years. Increased ADHD symptoms were directly associated with reduced adherence to controller medications, but no evidence of mediation was observed. Direct effects of ADHD symptoms on quick-relief medication use, health care utilization, asthma control, or pulmonary function were not observed. However, the effect of ADHD symptoms on emergency room visits was mediated by controller medication adherence. DISCUSSION: ADHD symptoms were associated with significantly reduced asthma controller medication adherence and indirectly with emergency room visits. There are significant potential clinical implications to these findings, including the need for the development of interventions for pediatric asthma patients with ADHD.

APA Citation

Silverstein, Gabriella D.; Arcoleo, Kimberly; Rastogi, Deepa; Serebrisky, Denise; Warman, Karen; and Feldman, Jonathan M., "The Relationship Between Pediatric Attention-Deficit/Hyperactivity Disorder Symptoms and Asthma Management" (2023). GW Authored Works. Paper 3899.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/3899

Department

Pediatrics