Communication during Pediatric Asthma Visits and Child Asthma Medication Device Technique 1 Month Later

Abstract

Objective. This study investigated how provider demonstration of and assessment of child use of asthma medication devices and certain aspects of provider–patient communication during medical visits is associated with device technique 1 month later. Methods. Two hundred and ninety-six children aged 8–16 years with persistent asthma and their caregivers were recruited at five North Carolina pediatric practices. All of the medical visits were audio-tape recorded. Children were interviewed 1 month later and their device technique was observed and rated. Results. If the provider asked the child to demonstrate metered dose inhaler technique during the medical visit, then the child was significantly more likely to perform a greater percentage of inhaler steps correctly 1 month later. Children with higher asthma management self-efficacy scores were significantly more likely to perform a greater percentage of diskus steps correctly. Additionally, children were significantly more likely to perform a greater percentage of diskus steps correctly if the provider discussed a written action plan during the visit. Children were significantly more likely to perform a greater percentage of turbuhaler steps correctly if they asked more medication questions. Conclusions. Providers should ask children to demonstrate their inhaler technique during medical visits so that they can educate children about proper technique and improve child asthma management self-efficacy. Providers should encourage children to ask questions about asthma medication devices during visits and they should discuss asthma action plans with families.

• device technique
• medication questions
• self-efficacy
• written action plans