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Communication during pediatric asthma visits and child asthma medication device technique 1 month later
Betsy Sleath1, Delesha M Carpenter, Guadalupe X Ayala
1Division of Pharmaceutical Outcomes and Policy, University of North Carolina Eshelman School of Pharmacy, Chapel Hill, 27599-7573, USA. betsy_sleath@unc.edu
Insights
Pediatricians asking children to demonstrate inhaler technique improves medication adherence. Discussing asthma action plans and encouraging questions also enhances correct inhaler device use and self-efficacy.
Area of Science:
- Pediatric pulmonology
- Respiratory medicine
- Health services research
Background:
- Proper use of asthma medication devices is crucial for effective asthma management in children.
- Provider-patient communication and direct assessment of technique can influence adherence and outcomes.
Purpose of the Study:
- To examine the association between provider assessment of child's asthma medication device technique and communication during visits and the child's technique one month later.
- To identify communication strategies that improve pediatric asthma medication adherence.
Main Methods:
- 296 children (8-16 years) with persistent asthma and caregivers were enrolled from five North Carolina pediatric practices.
- Medical visits were audio-recorded, and children's device technique was assessed one month post-visit.
Main Results:
- Direct demonstration of metered dose inhaler technique by the provider correlated with improved correct inhaler steps one month later.
- Higher asthma management self-efficacy and discussion of a written action plan were linked to better Diskus device technique.
- Children asking more medication questions showed improved Turbuhaler technique.
Conclusions:
- Providers should have children demonstrate inhaler technique to provide education and boost self-efficacy.
- Encouraging children's questions about asthma medications and discussing action plans with families are recommended strategies to improve pediatric asthma care.
Objective:
This study investigated how provider demonstration of and assessment of child use of asthma medication devices and certain aspects of provider-patient communication during medical visits is associated with device technique 1 month later.
Methods:
Two hundred and ninety-six children aged 8-16 years with persistent asthma and their caregivers were recruited at five North Carolina pediatric practices. All of the medical visits were audio-tape recorded. Children were interviewed 1 month later and their device technique was observed and rated.
Results:
If the provider asked the child to demonstrate metered dose inhaler technique during the medical visit, then the child was significantly more likely to perform a greater percentage of inhaler steps correctly 1 month later. Children with higher asthma management self-efficacy scores were significantly more likely to perform a greater percentage of diskus steps correctly. Additionally, children were significantly more likely to perform a greater percentage of diskus steps correctly if the provider discussed a written action plan during the visit. Children were significantly more likely to perform a greater percentage of turbuhaler steps correctly if they asked more medication questions.
Conclusions:
Providers should ask children to demonstrate their inhaler technique during medical visits so that they can educate children about proper technique and improve child asthma management self-efficacy. Providers should encourage children to ask questions about asthma medication devices during visits and they should discuss asthma action plans with families.
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