The Challenges of Young Adult Asthma

Asthma care harder for young adults to access as they grow up and leave home

(RxWiki News) With asthma, sometimes the simple act of breathing can be a real challenge. For young adults with asthma, the transition from living with parents to moving out on their own may present another challenge: maintaining access to asthma care.

A recent study looked at differences between the asthma control habits of older adolescents and young adults in the United States.

The results showed that young adults who left home and lost insurance coverage were less likely to use proper asthma control methods and more likely to visit the emergency department for asthma attacks.

"For asthma control, see a doctor every six months."

Kao-Ping Chua, MD, from the Division of Emergency Medicine at Boston Children’s Hospital and J. Michael McWilliams, MD, assistant professor of health care policy and medicine at Harvard Medical School and Brigham and Women’s Hospital, worked together to investigate the differences in care for adolescent and adult asthma patients.

“Compared with adolescents, young adults use less primary care and rely more heavily on emergency departments for care,” said the authors.

For the study, the researchers looked at data from national surveys from 1999 to 2009 on household medical expenses. Each participating household was interviewed five times over a two-year period.

The participating households had a total of 2,485 adolescents (aged 14 to 17 years) and young adults (aged 19 to 25 years) who either had a current diagnosis of asthma, had been treated for an asthma attack or had missed a day of school or work due to an asthma attack.

Eighteen-year-olds were left out of the study due to changes in insurance coverage, schooling and living situations common to transitioning into adulthood in the US.

The researchers looked at the following variables:

  • Primary care visits
  • Prescriptions for short-acting beta-agonists (SABAs), such as an inhaler
  • Asthma control medications, such as corticosteroids or long-acting inhalers
  • Visits to an emergency department
  • Cost or insurance coverage-related barriers to accessing proper medical care or prescription medications

The results showed that 79 percent of adolescents had a usual source of asthma care, compared to 66 percent of young adults.

A total of 58 percent of adolescents had a primary care visit in the last year, compared to 44 percent of young adults.

While 45 percent of adolescents filled SABA prescriptions within the past year, 35 percent of young adults had filled a prescription.

A total of 29 percent of young adults had been to a hospital emergency room in the past year for an asthma attack, compared to 19 percent of adolescents.

Insurance-related problems with accessing medical care occurred in 8 percent of young adults, compared to 3 percent of adolescents.

Insurance-related problems with accessing prescription medications occurred in 5 percent of young adults, compared to 2 percent of adolescents.

The researchers also found that young adults that did not continue with their education and moved out on their own were more likely to use SABA prescriptions, which are not control medications but short-term solutions.  

The authors suggested that college students were likely to have better access to primary and preventive care for asthma control than non-students.

“In this national representative study, young adults with asthma were less likely than older adolescents with asthma to have a usual source of care and less likely to use primary or preventive care,” the authors wrote.

The authors concluded that young adults with asthma have worse health care access and receive less than optimal care. The national guidelines recommend that young adults see a healthcare provider at least once every six months to monitor and control their asthma.

This study was published in April in Pediatrics.

The National Institute on Aging, the Doris Duke Charitable Foundation and the Harvard Pediatric Health Services Research Fellowship provided funding for this project. No conflicts of interest were found.

Review Date: 
April 22, 2013