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Parental asthma education and risks for nonadherence to pediatric asthma treatments
Eva M Delgado1, Christine S Cho, Ginny Gildengorin
1From the *Division of Pediatric Emergency Medicine, Children's Hospital of Philadelphia, Philadelphia, PA; †Departments of Pediatrics and Emergency Medicine, University of California San Francisco, San Francisco, CA; ‡Children's Hospital Oakland Research Institute; §Department of Emergency Medicine, Children's Hospital and Research Center Oakland, Oakland, CA; and ∥Division of Emergency Medicine, Department of Pediatrics, Emory Children's Center for Cystic Fibrosis and Airways Disease Research, Emory University School of Medicine, Atlanta, GA.
Insights
Parental education sources for pediatric asthma did not correlate with treatment nonadherence. Emergency department parents faced more nonadherence risks, highlighting the need for targeted primary care and Spanish-language asthma education.
Area of Science:
- Pediatric Pulmonology
- Health Education
- Behavioral Science
Background:
- Targeted parental education is known to decrease pediatric asthma emergency visits.
- The relationship between accessible asthma education sources and treatment nonadherence in parents is not well understood.
Purpose of the Study:
- To describe asthma education sources used by caregivers of children with asthma.
- To assess the association between these education sources and risks for nonadherence to asthma treatments.
Main Methods:
- A cross-sectional survey was administered to 260 caregivers of children with asthma at a pediatric emergency department and an asthma clinic.
- Data collected included usage of 7 education sources, child asthma morbidity, parental asthma knowledge, and risks for nonadherence.
- Statistical analyses included descriptive statistics, bivariate analyses, and multivariate regressions.
Main Results:
- Caregivers utilized various education sources, reporting an average of 4.1 risk factors for nonadherence.
- Parents recruited from the emergency department reported more nonadherence risks than those from the asthma clinic.
- No significant relationship was found between the number of education sources used and nonadherence risks; however, emergency department recruitment, Spanish language preference, and higher child morbidity were associated with increased risks.
Conclusions:
- Increased use of asthma education sources was not linked to lower risks of nonadherence.
- Primary care providers may be a beneficial education source for emergency department parents, particularly regarding medication refills and education.
- Spanish-speaking parents reported higher nonadherence risks, suggesting a need for further investigation and development of Spanish-language asthma education resources.
Objectives:
Targeted parental education reduces acute visits for pediatric asthma. Whether the use of education sources readily available to parents relates to nonadherence to asthma treatments is uncertain. This study describes asthma education sources and assesses for a relationship to risks for nonadherence.
Methods:
Caregivers of children with asthma completed a cross-sectional survey at 2 sites: a pediatric emergency department (ED) and an asthma clinic (AC). Measured items included the use of 7 education sources (primary care, ED, AC, friends/family, TV, internet, and printed materials), scores of child asthma morbidity, parental asthma knowledge, and risks for nonadherence, the primary outcome. Recruitment site, preferred language (English/Spanish), and demographics were recorded. Descriptive statistics, bivariate analyses, and multivariate regressions were performed.
Results:
A total of 260 participants, 158 from ED and 102 from AC, used a variety of education sources. They reported 4.1 (2.0) of 13 risk factors for nonadherence, with more risks in ED parents than AC parents (4.8 vs 3.9, P < 0.001). The ED parents worried more about medications and had worse access to primary care. The regression did not show a significant relationship between education sources and risks for nonadherence, but ED recruitment, Spanish language, and worse morbidity contributed to higher risks.
Conclusions:
The use of more asthma education sources was not associated with reduced risks for nonadherence. Of the education sources, a primary care provider may benefit ED parents, who also need refills and education about medications. Spanish-speaking parents report more risks for nonadherence, warranting further study of Spanish-language asthma education.
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