Improving Asthma Communication in High-Risk Children

Abstract

Few child asthma studies address the specific content and techniques needed to enhance child communication during asthma preventive care visits. This study examined the content of child and parent communications regarding their asthma management during a medical encounter with their primary care provider (PCP). The majority of parents and children required prompting to communicate symptom information to the PCP during the clinic visit. Some high-risk families may require an asthma advocate to ensure that the clinician receives an accurate report of child's asthma severity and asthma control to ensure prescribing of optimal asthma therapy.

Physician Behavior in the Care of Pediatric Chronic Illness: Association With Health Outcomes and Treatment Adherence

“…Successful intervention programs that have enhanced physicians' chronic illness management based on guidelines provide models for future adherence promotion efforts that may be extended to practice settings. [37][38][39][40][41] Moreover, providing primary care preventive visits to children with special health care needs is another avenue for adherence promotion that should be studied. 2 One model of comprehensive chronic illness management that has shown promise with adults with chronic illness and is applicable to pediatric chronic illness is the model of self-management support by Glasgow et al 55 This model includes 5 basic elements: (1) assess, which involves assessment of beliefs, behavior and knowledge;…”

“…Although adherence is one of a number of factors that can influence symptom control, health care utilization, and health-related quality of life, it may have a significant impact on these outcomes. 3,4,6,7 Moreover, studies that have indicated positive changes in clinically relevant outcomes, including treatment adherence, following interventions that enhanced physicians' management of pediatric asthma [37][38][39][40][41] underscore the need to test such interventions in a broader range of chronic conditions. Moreover, future descriptive research on physician communication and clinical management in pediatric chronic illness should include clinically relevant outcomes, especially measures of treatment adherence.…”

“…36 Finally, the results of several controlled intervention studies designed to enhance physicians' management of pediatric asthma have shown promising results in enhancing the quality of chronic illness care and improving clinical outcomes, including patient adherence. [37][38][39][40][41] …”

Caregiver perception of asthma management of children in the context of poverty

“…Encouraging caregivers to voice their concerns and beliefs about home asthma care with their child’s provider, followed by the development of a shared decision-making plan, may build rapport-building between providers and caregivers, illuminate ineffective or inaccurate home management of acute exacerbations, and enhance caregiver quality-of-life [24,25]. …”

Asthma in Head Start children: Effects of the Breathmobile program and family communication on asthma outcomes

“…(17) Previous studies have shown that children with asthma and their parents can be educated to communicate this information more effectively with their providers following home-based education interventions. (3;18) Moreover, a stronger partnership and improved communication between patients and providers is associated with better asthma control, fewer exacerbations, better quality of life, fewer sleep disturbances, and fewer patient-reported symptoms. (5;19) …”