Communication During Pediatric Asthma Visits and Self-Reported Asthma Medication Adherence

被引:78
|
作者
Sleath, Betsy [1 ,2 ]
Carpenter, Delesha M.
Slota, Catherine
Williams, Dennis
Tudor, Gail [3 ]
Yeatts, Karin [4 ]
Davis, Stephanie [5 ]
Ayala, Guadalupe X. [6 ]
机构
[1] Univ N Carolina, Div Pharmaceut Outcomes & Policy, Eshelman Sch Pharm, Chapel Hill, NC 27599 USA
[2] Univ N Carolina, Cecil G Sheps Ctr Hlth Serv Res, Chapel Hill, NC 27599 USA
[3] Husson Univ, Dept Sci & Math, Bangor, ME USA
[4] Indiana Univ Sch Med, Dept Epidemiol, Indianapolis, IN USA
[5] Indiana Univ Sch Med, Riley Hosp Children, Indianapolis, IN USA
[6] San Diego State Univ, Grad Sch Publ Hlth, Div Hlth Promot & Behav Sci, San Diego, CA 92182 USA
基金
美国国家卫生研究院;
关键词
adherence; asthma; pediatric; communication; CHILD; MANAGEMENT; BARRIERS; BELIEF;
D O I
10.1542/peds.2012-0913
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
OBJECTIVE: Our objectives were to examine how certain aspects of provider-patient communication recommended by national asthma guidelines (ie, provider asking for child and caregiver input into the asthma treatment plan) were associated with child asthma medication adherence 1 month after an audio-taped medical visit. METHODS: Children ages 8 through 16 with mild, moderate, or severe persistent asthma and their caregivers were recruited at 5 pediatric practices in nonurban areas of North Carolina. All medical visits were audio-tape recorded. Children were interviewed 1 month after their medical visits, and both children and caregivers reported the child's control medication adherence. Generalized estimating equations were used to determine if communication during the medical visit was associated with medication adherence 1 month later. RESULTS: Children (n = 259) completed a home visit interview similar to 1 month after their audio-taped visit, and 216 of these children were taking an asthma control medication at the time of the home visit. Children reported an average control medication adherence for the past week of 72%, whereas caregivers reported the child's average control medication adherence for the past week was 85%. Child asthma management self-efficacy was significantly associated with both child-and caregiver-reported control medication adherence. When providers asked for caregiver input into the asthma treatment plan, caregivers reported significantly higher child medication adherence 1 month later. CONCLUSIONS: Providers should ask for caregiver input into their child's asthma treatment plan because it may lead to better control medication adherence. Pediatrics 2012; 130: 627-633
引用
收藏
页码:627 / 633
页数:7
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