Asthma Communication & Adherence In Inner-City Children

描述（由申请人提供）： 与哮喘相关的发病率和死亡率在市中心的非洲裔美国儿童中不成比例地高。非裔美国人和贫困儿童有更高的急诊使用率，住院率，生活质量下降，致命性哮喘的风险增加。研究表明，非洲裔美国儿童不太可能接受基于指南的护理，这可能是他们发病率增加的原因。家庭医生对哮喘的沟通不足，包括症状严重程度、处方方案、儿童正在使用的其他药物以及疾病管理的心理障碍，可能导致哮喘管理较差。对成人的研究将医生与患者的沟通与各种健康结果联系起来，包括症状解决，功能状态，生理措施和疼痛控制，以及对医疗信息的回忆和理解。此外，对成年人的研究表明，改善沟通可以提高患者的依从性。然而，这种关系还没有得到证实，使用客观的措施，服药依从性。此外，很少有研究调查家庭医生沟通和儿童的健康结果之间的关系，特别是在市中心的哮喘儿童。一项专注于改善医生哮喘沟通技巧的干预研究发现，改善沟通导致医生增加了对基于指南的哮喘管理的依从性，并对儿童的医疗保健利用率产生了中度影响。研究人员没有评估改善沟通对哮喘家庭管理的影响。因此，本申请的目的是开发一种儿科哮喘沟通工具（PACT），并对PACT作为以患者为中心的沟通干预的一部分的效用进行初步研究，以改善家庭医生沟通和随后的哮喘药物依从性。 (End摘要）

DESCRIPTION (provided by applicant): Asthma-related morbidity and mortality are disproportionately high among inner-city African-American children. African-American and poor children have higher rates of emergency department use, hospitalization, decreased quality of life, and increased risk of fatal asthma. Research has shown that African-American children are less likely to receive guideline-base care, which may account for their increased morbidity. Inadequate family-physician communication about asthma, including symptom severity, the prescribed regimen, other medications the child is using and psychosocial barriers to illness management may contribute to poorer asthma management. Research with adults has linked physician patient communication to a variety of health outcomes, including symptom resolution, functional status, physiologic measures and pain control, and recall and understanding of medical information. Furthermore, research with adults suggests that improved communication results in better patient adherence. However, this relationship has not been corroborated using objective measures of medication adherence. Moreover, little research has been conducted examining the relationship between family-physician communication and children's health outcomes, particularly in inner-city children with asthma. One intervention study that focused on improving physicians' asthma communication skills found that improved communication resulted in physicians increased adherence to guideline-based asthma management and had a moderate impact on the child's health care utilization. The researchers did not assess the impact of improved communication on family management of asthma. Thus, the purpose of this application is to develop a pediatric asthma communication tool (PACT) and conduct a pilot study of the utility of the PACT as part of a caregiver-focused communication intervention to improve family-physician communication and subsequent asthma medication adherence. (End of Abstract)