Caregiver input helps asthmatic children stick to their medicine regimens
|September 27, 2012|
Asthmatic children do a better job of taking their medications if their caregivers are included in decision-making, according to a new study from the University of North Carolina at Chapel Hill.
Karin Yeatts, PhD, research assistant professor of epidemiology at UNC Gillings School of Global Public Health, is co-author of the study.
“‘Patient-centered’ approaches have been introduced as an effective way to involve and motivate the patient,” Yeatts said. “We investigated whether certain aspects of provider-patient communication recommended by national asthma guidelines were associated with child asthma medication adherence.”The National Asthma Education and Prevention Program proposes that physicians discuss medications with patients at every follow-up asthma visit and aim to determine treatment goals jointly with the patient’s family.
The research team, led by Betsy Sleath, PhD, George H. Cocolas Distinguished Professor and chair of the Division of Pharmaceutical Outcomes and Policy at the UNC Eshelman School of Pharmacy, wanted to know whether the joint effort would improve how well children adhere to their treatment regimen.
The researchers recruited 296 children ages 8 to16 who have persistent asthma, along with their caregivers, at five pediatric practices in nonurban areas of North Carolina. Of those, 259 children were interviewed one month after their medical visits, and both children and caregivers reported the child’s control medication adherence.
Generalized estimating equations were used to determine whether communication during the medical visit was associated with medication adherence one month later. The findings were published online Sept. 3 in the journal Pediatrics.
“We found that when the physician included the caregiver in developing the treatment plan, the caregivers reported that their children took their medicine as directed 80 percent of the time, compared to only 72 percent in cases where the physician did not include caregiver input,” Yeatts said. “Our study indicates an important area for improving asthma management through provider caretaker communication. In our study, only 7.8 percent of providers asked caretakers/parents for their input in the asthma management plan.”
“Getting caregivers involved in treatment decisions can help their children use asthma medications more effectively and consistently,” Sleath said.
UNC co-authors are Delesha M. Carpenter, PhD, MSPH, research assistant professor at the pharmacy school and adjunct assistant professor of health behavior at the public health school; pharmacy graduate student Catherine Slota; and pharmacy associate professor Dennis Williams, PharmD. Additional coauthors are Gail Tudor, PhD, of Husson University, in Bangor, Maine; Stephanie Davis, MD, of the Riley Hospital for Children, in Indianapolis; and Guadalupe X. Ayala, PhD, MPH, of San Diego State University.