Group discussions with parents have long-term positive effects on the management of asthma with good cost-benefit

Hederos, Carl-Axel; Janson, Staffan; Hedlin, Gunilla

doi:10.1080/08035250410023322

Cited by 15 publications

(25 citation statements)

References 23 publications

(21 reference statements)

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“…For example, children were expected to include parents in “homework” activities or parents and children were expected to practice new ways of resolving problems or conflicts. Other forms of active participation included parent record keeping of the child’s daily symptoms (Collandra et al, 2004) and group sessions where parents shared their experiences with one another (Hederos, Janson, & Hedlin, 2005; Hederos, Janson, & Hedlin, 2007; Hederos, Janson, & Hedlin, 2009). …”

Section: Resultsmentioning

confidence: 99%

The Nature of Family Engagement in Interventions for Children With Chronic Conditions

et al. 2016

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Recognizing the bi-directional relationship between family functioning and child wellbeing in the context of childhood chronic conditions, researchers have tested family-focused interventions aimed at promoting both child and family well-being through improving the family’s condition management capacity. Based on a sample of 70 interventions for families in which there was a child with a chronic physical condition, this analysis examined the nature of family engagement in the interventions. Data were extracted from the intervention reports using a standardized template; conventional content analysis was used to describe family engagement. Interventions varied in focus, structure, and level of family engagement. Investigators most often sought to improve condition control or management, with parent engagement focused on improving capacity to manage the treatment regimen. Few investigators addressed capacity building in the context of family functioning. Recommendations are made for reporting standards for family-focused interventions and for enhancing the family systems grounding of interventions.

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Section: Resultsmentioning

confidence: 99%

The Nature of Family Engagement in Interventions for Children With Chronic Conditions

et al. 2016

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“…The new composition could have reduced the interaction between participants. Interaction was shown to be effective in preventing paediatric asthma exacerbations …”

Section: Discussionmentioning

confidence: 99%

Effects of shared medical appointments compared to individual appointments in children with atopic dermatitis: A pragmatic randomized controlled trial

Zijlstra

Os‐Medendorp

Fieten

et al. 2019

Clin Experimental Allergy

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Background: Atopic dermatitis (AD) needs intensive treatment and has a negative impact on quality of life. Shared medical appointments (SMAs) showed to be effective in clinical outcomes of chronic diseases, but little is known about the effects on children and families.Objective: To evaluate the effects of SMAs compared to individual appointments (IA) for children with AD and their parents on coping and clinical outcomes. Methods:In a pragmatic randomized controlled trial, new patients in UMC Utrecht with AD, younger than 18 years, and their parents were assigned to the SMA group or the IA group using a covariate adaptive randomization method, controlled for age.Before the intervention, 2 months (primary time-point) and 6 months thereafter, we assessed parental emotional coping (primary outcome), quality of life, anxiety about corticosteroids and patient disease activity. Patients, parents and healthcare professionals could not be blinded to group assignment. Results:Of 140 patients, enrolled in the trial, 69 patients were assigned to the SMA and 71 to the IA intervention of whom 114 completed the intervention (SMA: 49; IA: 65). After 2 months, there were no differences between SMAs and IAs in effects on emotional coping: b 0.66, 95% CI −0.7 to 2.03; P = 0.33 (mean difference: 0.30; 95% CI −1.56 to 2.16; N SMA: 11; IA: 24), quality of life, anxiety about corticosteroids and disease activity. From the initial appointment to long-term follow-up, both groups showed substantial improvements, but not significant in disease activity and significant reduction in anxiety about corticosteroids. This study is limited by a low response rate; therefore, linear mixed models and dropout analyses were performed.No serious adverse events were reported. Conclusion and ClinicalRelevance: For children with AD and their parents, there were no additional benefits of GMAs in parental emotional coping, anxiety about corticosteroids, quality of life and disease activity. Trial registration: www.ISRCTN.org, ISRCTN08506572.

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“…The HCP delivering the intervention Only 14 of the inter ventions were delivered by doctors. 29,35,38,53,61,64,72,87,95,96,98,110 The rest of the interventions were delivered by different types of pharmacists (clinical, hospital, community, research, senior, or unspecified).…”

Section: Other Biasmentioning

confidence: 99%

“…In four studies, the doctor delivered the intervention in collaboration with other HCPs. 53,64,77,87 Tailored versus fixed interventions…”

Section: Clinical Diseasesmentioning

confidence: 99%

“…67,78,109 In the studies in which the interventions were tailored, the HCP tailored the interventions based on patients' needs, giving tailored information and advice 36,46,50,120 and prioritizing the recommendations based on the patients' medical records. 62,107 Hederos et al 64 used the concept of "concordance" (defined as reaching an agreement with parents of pediatric patients on how to look upon asthma and its management). They used this approach with the hypothesis that the parents would understand the advice and education better.…”

Section: Clinical Diseasesmentioning

confidence: 99%

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Delivery of patient adherence support: a systematic review of the role of pharmacists and doctors

Andersson¹,

Garfield²,

Eliasson³

et al. 2014

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We conducted a systematic review of adherence support programs involving doctors and pharmacists. We searched MEDLINE ® , Embase, International Pharmaceutical Abstracts, PsycINFO ® , and CINAHL using the keywords "pharmacist" or "doctor" and "adhere*" or " compli*" and "randomized controlled trials". We found 89 studies involving pharmacists; in contrast, only 14 studies involved doctors. The roles of pharmacists and doctors ranged from providing education and counseling to adjusting treatment. Most interventions that specified a patient group were carried out with patients with chronic conditions (n=79) and only six included short-term treatments. The majority of interventions improved adherence and clinical outcomes to some extent, although the size of effect size was sometimes small. Resource utilization (eg, hospitalization rates, visits to doctors) did not change in the majority of studies that reported it. Few studies included cost analyses. All but one study had high risk of performance bias due to the nature of the interventions, which made it impossible to blind the participants. The majority of studies did not report tailoring the interventions to patient needs and the vast majority of papers did not report taking a concordant patient-centered approach or considering patients' own views and experiences when providing adherence support. In addition, the majority of studies did not describe training for the health care professionals involved in providing adherence support. Providing training for doctors and pharmacists to take a more patient-centered concordant approach would be expected to increase the effectiveness of adherence support further.

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Group discussions with parents have long-term positive effects on the management of asthma with good cost-benefit

Abstract: This intervention resulted in an improvement in the parents' view on adherence, in the measured adherence rates and in the clinical outcome.

Cited by 15 publications

References 23 publications

The Nature of Family Engagement in Interventions for Children With Chronic Conditions

The Nature of Family Engagement in Interventions for Children With Chronic Conditions

Effects of shared medical appointments compared to individual appointments in children with atopic dermatitis: A pragmatic randomized controlled trial

Delivery of patient adherence support: a systematic review of the role of pharmacists and doctors

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