Developing an adapted parent-youth teamwork intervention to improve medication adherence among adolescents with asthma: a feasibility study

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Asthma affects one in 11 children and adolescents in the UK and can have a major impact on adolescents' quality of life and their health care use. Daily use of an asthma preventer inhaler is the most effective way to reduce symptoms and allow children and adolescents to lead a normal life. Research studies have shown that adolescents in particular struggle with taking their inhaler medication regularly. Therefore, parental support for taking medication regularly is important. However, in this age group peer support becomes more and more critical. Thus, support from parents and peers can be used to help adolescents to take their medication regularly. There is currently no programme in the NHS to help parents and adolescents to take asthma medication regularly. We have identified a very promising parent-youth teamwork programme, developed and tested in the United States, that provide such support. This programme includes: (a) discussing learning materials and worksheets about reasons for taking asthma medication regularly, and about how important family communication is for taking medication; (b) using role play and problem-solving techniques to define the problem, find alternatives and solutions; (c) discussing the family's challenges associated with taking asthma medication regularly; and (d) formulating goals and realistic plans how to take asthma medication regularly. In this programme, electronic monitors (so-called smart inhalers) to be attached to the actual inhaler, were used to record if the preventer inhaler was used as prescribed. For the programme, parents and adolescents used these data to formulate their goals and actions plans. We propose to adapt this programme to the UK NHS context, and strengthen it by applying the latest research findings as well as input from adolescents, parents, and care providers. Importantly, we will develop and evaluate an additional novel component on peer support. To make this program sustainable within the UK NHS context, an asthma nurse will be delivering this programme. Therefore, we will develop a manual to efficiently train asthma nurses. After that, we will test the feasibility of this new programme with up to 10 adolescents and their parents to evaluate how it would be delivered in the UK NHS; and what adolescents, parents and care providers think about this new programme. The results of our study will pave the way to a larger scale intervention that may encourage adolescents to take their asthma medications regularly, help manage their asthma effectively, and improve their quality of life.