Communication During Pediatric Asthma Visits and Self-Reported Asthma Medication Adherence
Communication During Pediatric Asthma Visits and Self-Reported Asthma Medication Adherence
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DOI：
10.1542/peds.2012-0913
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发表时间：
2012-10-01
期刊：
影响因子：
8
通讯作者：
Ayala, Guadalupe X.
中科院分区：
文献类型：
--
作者：
Sleath, Betsy;Carpenter, Delesha M.;Ayala, Guadalupe X.
目的：我们的目的是研究国家哮喘指南推荐的某些方面的医患沟通（即，提供者要求儿童和照顾者输入哮喘治疗计划）与儿童哮喘药物治疗依从性有关，1个月后进行了录音医疗访问。在北卡罗来纳州非城市地区的5个儿科诊所招募了8 - 16岁的轻度、中度或重度持续性哮喘儿童及其护理人员。所有的医疗访问都有录音带记录。儿童在就诊后1个月接受了采访，儿童和照顾者都报告了儿童的对照药物依从性。广义估计方程，以确定是否在医疗访问期间的通信与药物adherence 1 month later.RESULTS：儿童（n = 259）完成了一个家庭访问访谈类似的1个月后，他们的录音访问，和216这些儿童正在服用哮喘控制药物的时间在家庭访问。儿童在过去一周的平均控制药物依从性为72%，而照顾者报告儿童在过去一周的平均控制药物依从性为85%。儿童哮喘管理自我效能与儿童和成人报告的控制药物依从性显著相关。当供应商要求照顾者输入到哮喘治疗计划，照顾者报告显着较高的儿童药物adherence 1 month later.CONCLUSIONS：供应商应要求照顾者输入到他们的孩子的哮喘治疗计划，因为它可能会导致更好的控制药物依从性。儿科2012; 130：627-633
OBJECTIVE: Our objectives were to examine how certain aspects of provider-patient communication recommended by national asthma guidelines (ie, provider asking for child and caregiver input into the asthma treatment plan) were associated with child asthma medication adherence 1 month after an audio-taped medical visit.METHODS: Children ages 8 through 16 with mild, moderate, or severe persistent asthma and their caregivers were recruited at 5 pediatric practices in nonurban areas of North Carolina. All medical visits were audio-tape recorded. Children were interviewed 1 month after their medical visits, and both children and caregivers reported the child's control medication adherence. Generalized estimating equations were used to determine if communication during the medical visit was associated with medication adherence 1 month later.RESULTS: Children (n = 259) completed a home visit interview similar to 1 month after their audio-taped visit, and 216 of these children were taking an asthma control medication at the time of the home visit. Children reported an average control medication adherence for the past week of 72%, whereas caregivers reported the child's average control medication adherence for the past week was 85%. Child asthma management self-efficacy was significantly associated with both child-and caregiver-reported control medication adherence. When providers asked for caregiver input into the asthma treatment plan, caregivers reported significantly higher child medication adherence 1 month later.CONCLUSIONS: Providers should ask for caregiver input into their child's asthma treatment plan because it may lead to better control medication adherence. Pediatrics 2012; 130: 627-633