Evidence map›Paper›PMID 36229143›Full record

ArticleBMJ open2022

Prevalence of polypharmacy and associated adverse outcomes and risk factors among children with asthma in the USA: a cross-sectional study.

Luyu Xie, Andrew Gelfand, Caitlin C Murphy, M Sunil Mathew, Folefac Atem, George L Delclos, Sarah Messiah

Open access · goldAbstract read
In one paragraph

Article in BMJ open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.5field-weighted citation impact, top 37% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 4 citations in OpenAlex.

  1. Trends in Coprescription Among Taiwanese Children from 2002 to 2012.Journal of multidisciplinary healthcare · 2023
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 1 country.

Luyu XieDeparment of Epidemiology, Human Genetics & Environmental Sciences, University of Texas Health Science Center at Houston, Dallas, Texas, USA.ORCID 0000-0003-4499-0555
Andrew GelfandDepartment of Pediatrics, The University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Caitlin C MurphyDepartment of Health Promotion & Behavioral Sciences, University of Texas Health Science Center at Houston, Houston, Texas, USA.
M Sunil MathewDeparment of Epidemiology, Human Genetics & Environmental Sciences, University of Texas Health Science Center at Houston, Dallas, Texas, USA.
Folefac AtemCenter for Pediatric Population Health, UTHealth School of Public Health, Dallas, Texas, USA.ORCID 0000-0002-1142-7806
George L DelclosDeparment of Epidemiology, Human Genetics & Environmental Sciences, University of Texas Health Science Center at Houston, Houston, Texas, USA.
Sarah MessiahDeparment of Epidemiology, Human Genetics & Environmental Sciences, University of Texas Health Science Center at Houston, Dallas, Texas, USA Sarah.E.Messiah@uth.tmc.edu.ORCID 0000-0001-6685-2175
University of Texas Health Science Center at Dallas · USThe University of Texas Health Science Center at Houston · USThe University of Texas Southwestern Medical Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo estimate the prevalence of polypharmacy, identify risk factors and examine related adverse outcomes in the US children with asthma. DESIGN, SETTING AND

participantsThis population-based, cross-sectional study included 1776 children with asthma from the 2011-2020 National Health and Nutrition Examination Surveys. EXPOSURES: Polypharmacy is defined as taking ≥2 medications concurrently for ≥1 day over the past 30 days. MAIN OUTCOMES AND MEASURES: (1) Weighted prevalence estimates of polypharmacy in children with asthma; (2) asthma attacks and emergency department (ED) visits.

resultsThe estimated prevalence of polypharmacy in the US children with asthma was 33.49% (95% CI 31.81% to 35.17%). 15.53% (95% CI 14.31% to 16.75%), 12.63% (95% CI 11.37% to 13.88%) and 5.33% (95% CI) of participants were taking 2, 3-4, and 5 prescription medications, respectively. In addition to asthma medications, the most common sources of polypharmacy included antihistamines (20.17%, 95% CI 16.07% to 24.28%), glucocorticoids (16.67%, 95% 12.57% to 20.78%), and anti-infectives (14.28%, 95% CI 10.29 to 18.28). Risk factors for the increased number of medications included age 5-11 years old (vs 1-4 years: adjusted incidence rate ratio (aIRR) 1.38, 95% CI 1.10 to 1.72), fair-to-poor health (vs excellent or very good: aIRR 1.42, 95% CI 1.05 to 1.92), or ≥6 healthcare utilisation encounters over the last year (vs 0-5 encounters: aIRR 1.45, 95% CI 1.26 to 1.66). Polypharmacy increased the odds of an asthma attack (adjusted OR (aOR) 2.80, 95% CI 1.99 to 3.93) and ED visit (aOR 2.41, 95%1.59-3.63) after adjusting for demographics, insurance and health status.

conclusionsEvery one in three US children with asthma experienced polypharmacy. Although it may reflect the treatment guidelines that various asthma medications are needed for maintenance therapy, our results suggested that polypharmacy increased the odds of asthma attacks or ED visits. This may be due to the concurrent use with other non-asthma medications indicating that there is an opportunity to improve medication management in children with asthma.

Indexed as

AsthmaPolypharmacyChildChild, PreschoolCross-Sectional StudiesHistamine AntagonistsHumansPrevalenceRisk FactorsUnited StatesHistamine AntagonistsAsthmaCommunity child healthEpidemiology

Identifiers

PMID36229143
PMCPMC9562747
OpenAlexW4304974355

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.