{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T14:01:50Z","timestamp":1784728910784,"version":"3.55.0"},"reference-count":39,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T00:00:00Z","timestamp":1779321600000},"content-version":"vor","delay-in-days":20,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Pulmonology"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Despite asthma being one of the most common chronic conditions among children in the United States, real\u2010world evidence on medication adherence and healthcare utilization in underserved pediatric populations remains limited. Therefore, we aim to evaluate adherence, persistence, and asthma\u2010related healthcare utilization among Medicaid\u2010enrolled children receiving inhaled corticosteroids (ICS) versus ICS\u2010long\u2010acting beta\u2010agonist (ICS\u2010LABA) inhalers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective cohort study using Texas Children's Health Plan claims data from 2016 to 2019. Children aged 4\u201317 years with asthma diagnoses and \u22651 prescription for an ICS or ICS\u2010LABA were included. Adherence was determined as the proportion of days covered (PDC) of \u2265 50%, and persistence was defined as continuous therapy without a 60\u2010day gap. The PDC\u2009\u2265\u200980% was evaluated in sensitivity analysis. Multivariable logistic regression was used to estimate adherence, asthma\u2010related emergency department (ED) visits, and hospitalizations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 8622 eligible children, 82.4% received ICS and 17.6% received ICS\u2013LABA. In inverse probability of treatment weighting (IPTW) adjusted analyses, compared with ICS, ICS\u2010LABA users had higher adherence rate i.e., 21.08% versus 16.56% achieved PDC\u2009\u2265\u200950% (aOR\u2009=\u20091.35; 95%CI: 1.25\u20131.45), and 10.82% versus 6.74% achieved PDC\u2009\u2265\u200980% (aOR\u2009=\u20091.61; 95%CI: 1.31\u20131.97). Refill persistence was also higher with ICS\u2010LABA (36.16% vs. 23.35%, aOR: 1.86, 95%CI: 1.74\u20131.99). However, despite better adherence, we found ICS\u2010LABA users exhibited greater asthma\u2010related healthcare utilization, i.e., ED visits occurred in 18.69% versus 11.25% (aOR\u2009=\u20091.81; 95%CI: 1.56\u20132.11) and hospitalizations in 2.53% versus 1.00% (aOR=\u20092.55; 95%CI: 1.68\u20133.89), which persisted even after adjusting for adherence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>We found that adherence was greater in children with asthma who were dispensed an ICS\u2010LABA as compared to those dispensed an ICS\u2010only inhaler; however, adherence rates were low in both groups. Higher hospitalization and ED visit rates among those prescribed ICS\u2010LABA therapy likely reflect higher disease severity in this group. Our findings should be interpreted in light of claims\u2010based adherence measures and potential residual confounding due to unmeasured asthma severity and control.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ppul.71673","type":"journal-article","created":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T08:40:07Z","timestamp":1779352807000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Association of Inhaled Corticosteroid and Long\u2010Acting Beta Agonist Combination Versus Inhaled Corticosteroid Only Inhalers on Adherence and Asthma Outcomes"],"prefix":"10.1002","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4850-9215","authenticated-orcid":false,"given":"Javeria","family":"Khalid","sequence":"first","affiliation":[{"name":"Pharmaceutical Health Outcomes and Policy, College of Pharmacy University of Houston Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hua","family":"Chen","sequence":"additional","affiliation":[{"name":"Pharmaceutical Health Outcomes and Policy, College of Pharmacy University of Houston Houston Texas USA"},{"name":"Population Health Outcomes and Pharmacoepidemiology Education and Research Center (P\u2010HOPER Center) University of Houston College of Pharmacy Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harold J.","family":"Farber","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Division of Pulmonology, Baylor College of Medicine Houston Texas USA"},{"name":"Texas Children's Hospital, Pulmonary Medicine Service Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,21]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2024.103051"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2022.823399"},{"key":"e_1_2_13_4_1","unstructured":"Prevention CfDCa Most Recent National Asthma Data. 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