Objectives: To examine trends in preventive asthma medication (PAM) use among children with current asthma in the United States from 1988 to 2008.

Methods: We performed a cross-sectional analysis of PAM use among 2499 children aged 1 to 19 years with current asthma using nationally representative data from the National Health and Nutrition Examination Survey (NHANES) during 3 time periods: 1988-1994, 1999-2002 and 2005-2008.  PAMs included inhaled corticosteroids, leukotriene receptor antagonists, long-acting beta-agonists, mast-cell stabilisers and methylxanthines.

Results: Among children with current asthma, there was an increase in the use of PAMs from 17.8% (SE: 3.3) in 1988-94 to 34.9% (SE: 3.3) in 2005-08 (P less than 0.001 for trend).  Adjusting for age, gender, race/ethnicity and health insurance status, the odds of PAM use were higher in 2005-08 compared with 1988-94 (adjusted odds ratio (aOR) = 2.6; 95% CI, 1.5 to 4.5).  A multivariate analysis, combining all 3 time periods, showed lower use of PAMs among non-Hispanic black (aOR = 0.5; 95% CI, 0.4 to 0.7) and Mexican-American (aOR = 0.6; 95% CI, 0.4 to 0.9) children compared to non-Hispanic white children.  PAM use was also lower in 12- to 19-year-olds compared with 1- to 5-year-olds and also in children who did not have health insurance compared with those who did.

Conclusions: Between 1988 and 2008, the use of PAM increased among children with current asthma.  Non-Hispanic black and Mexican American children, adolescents aged 12 to 19 years, and uninsured children with current asthma had lower use of PAM.