Discussions About Antibiotics During Adolescent Asthma Visits: Implications for Providers

Area of Science:

• Pediatric Pulmonology
• Antimicrobial Stewardship
• Health Communication

Background:

• Children with asthma experience higher antibiotic exposure than healthy peers.
• The quality of communication regarding antibiotic prescriptions in pediatric asthma care is not well understood.
• Effective communication is crucial for appropriate antibiotic use and patient adherence.

Purpose of the Study:

• To analyze the quality of provider-patient communication surrounding antibiotic prescriptions in adolescent asthma visits.
• To identify communication gaps and propose essential elements for antibiotic prescribing discussions.
• To inform future interventions aimed at improving antibiotic stewardship in pediatric asthma.

Main Methods:

• Secondary data analysis of 539 audiotaped adolescent asthma visit transcripts.
• Utilized a standardized coding sheet to evaluate communication quality regarding antibiotics.
• Identified and analyzed 12 instances of antibiotic-related discussions.

Main Results:

• Antibiotic discussions were infrequent, occurring in only 12 out of 539 visits.
• No patients or parents initiated requests for antibiotics.
• Discussions were often limited to drug allergies and formulation, with the antibiotic name omitted in 42% of cases.

Conclusions:

• Current communication practices regarding antibiotic prescriptions for pediatric asthma are inadequate.
• Essential communication elements, including drug name and dosing, are frequently missing.
• A structured approach to antibiotic prescribing conversations is needed to enhance patient understanding and antimicrobial stewardship.