The Effect of Risk and Side Effect Communication on Asthma Medication Adherence

风险和副作用沟通对哮喘药物依从性的影响

• 批准号: 8121213
• 负责人: Chris Gillette
• 金额: $ 3.31万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-07-01 至 2012-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8121213
• 关键词: Effect; Risk; Side; Communication; Asthma

DESCRIPTION (provided by applicant): Asthma is the most common chronic disease affecting US children. For those with persistent symptoms, optimal asthma symptom control is predicated on children taking daily control medications. Both national and international consensus groups recommend inhaled corticosteroids as the most effective asthma control medication. However, adherence to asthma control medications in children is consistently reported as poor across all control medication classes. The most common reasons for non-adherence to asthma control medications are parental distrust of asthma control medication and concerns over adverse events, especially growth velocity and final adult height. Since general medical providers rather than specialists treat most asthmatic children, it is important to study how general pediatricians communicate about the risks and side effects of asthma control medications. The proposed research is a secondary data analysis of survey and clinic visit audio - tapes that were collected in five rural general pediatric practices from 2006 through 2009 including 35 pediatricians and 296 of their patients with persistent asthma symptoms. Quantitative analyses employing generalized estimating equations will be conducted to examine the influence of child, caregiver, pediatrician, and medication characteristics on discussions of benefits, risks, and side - effects of asthma control medications. In addition, the proposed research will also examine how the above characteristics and discussions about benefits, risks, and side - effects affect control medication adherence one month after the initial audio - taped visit. The study will also qualitatively describe the risk communication that occurs during the visits. Understanding how pediatricians communicate with children and their caregiver(s) about the benefits, risks, and side - effects of asthma control medication will enable researchers to develop interventions that can improve communication during a pediatric office visits. However, very little is known about pediatrician- caregiver-child communication about asthma control medications. Risk communication research is a priority of the Food and Drug Administration and medication safety is a research priority of the Agency of Healthcare Research and Quality further highlighting the importance of this proposed research. Data from the proposed research could inform intervention strategies designed to improve patient-physician communication about the risks and benefits of asthma control medications. Such interventions have the potential to improve adherence to these medications and subsequently: (1) reduce absenteeism from school, (2) increase symptom - free days, (3) decrease asthma emergency department visits, and (4) reduce time lost from work for caregiver(s). PUBLIC HEALTH RELEVANCE: Asthma is the most common chronic health condition affecting US children. One of the Food and Drug Administration's research priorities is risk communication. This proposed research will examine how medical providers in general pediatric clinics discuss the risks, side effects, and benefits of asthma controller medications with primary caregivers and children by analyzing transcripts of audio taped asthma visits. This proposed research will then explore whether those discussions are related to asthma controller medication adherence one month after the audio taped asthma visit.

描述（由申请人提供）：哮喘是影响美国儿童的最常见慢性疾病。对于那些持续症状的人，最佳的哮喘症状控制基于服用日常控制药物的儿童。国家和国际共识小组都建议吸入的皮质类固醇是最有效的哮喘控制药物。但是，在所有对照药物类别中，始终遵守儿童哮喘控制药物。不遵守哮喘控制药物的最常见原因是父母对哮喘控制药物的不信任以及对不良事件的担忧，尤其是生长速度和最终的成人身高。由于普通医疗提供者而不是专家对待大多数哮喘儿童，因此重要的是要研究普通儿科医生如何就哮喘控制药物的风险和副作用进行交流。拟议的研究是对调查和诊所访问音频的二级数据分析 - 从2006年到2009年的五种农村一般儿科实践中收集的磁带，其中包括35名儿科医生和296名患有持续性哮喘症状的患者。将进行使用通用估计方程的定量分析，以检查儿童，照顾者，儿科医生和药物特征对哮喘控制药物的福利，风险和副作用的讨论的影响。此外，拟议的研究还将研究上述有关收益，风险和副作用的特征和讨论如何影响控制药物的依从性。该研究还将定性地描述访问期间发生的风险交流。了解儿科医生如何与儿童及其护理人员沟通有关哮喘控制药物的益处，风险和副作用，将使研究人员能够开发可以在儿科办公室就诊期间改善沟通的干预措施。但是，关于有关哮喘控制药物的儿科医生 - 护理人员 - 孩子的交流知之甚少。风险交流研究是食品药物管理局和药物安全的优先事项，是医疗研究和质量机构的研究优先事项，进一步强调了这项拟议研究的重要性。拟议研究的数据可以为旨在改善患者 - 医学沟通的干预策略提供信息，以了解哮喘控制药物的风险和益处。这种干预措施有可能提高对这些药物的依从性，随后是：（1）减少学校的缺勤，（2）增加症状 - 无日子，（3）减少哮喘急诊室就诊，（4）（4）减少为照料者工作而浪费的时间。 公共卫生相关性：哮喘是影响美国儿童的最常见慢性健康状况。食品和药物管理局的研究重点之一是风险交流。这项拟议的研究将研究一般儿科诊所中的医疗提供者如何通过分析录音带的哮喘访问的笔录来讨论哮喘控制器药物与主要护理人员和儿童的风险，副作用和益处。然后，这项拟议的研究将探讨这些讨论是否与哮喘控制器药物依从性相关，在音频录制哮喘访问后一个月。

项目成果

Provider-caregiver-child discussions about risks associated with asthma control medications: content and prevalence.

提供者-看护者-儿童关于哮喘控制药物相关风险的讨论：内容和患病率。

• DOI: 10.1002/ppul.22892
• 发表时间: 2014
• 期刊: Pediatric pulmonology
• 影响因子: 3.1
• 作者: Gillette,Chris;Blalock,SusanJ;Rao,JayaK;Williams,Dennis;Loughlin,CeilaE;Sleath,Betsy
• 通讯作者: Sleath,Betsy