June 02, 2016
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Parents’ understanding of asthma medications may not match with recommendations

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Recent research in the Journal of Allergy and Clinical Immunology found that provider recommendations for inhaled steroids do not align with guidelines, resulting in mismatched understanding and treatment behaviors among parents administering the medications.

“We need to improve provider-patient communication in the medical office, especially for controller medications for children with asthma, but providers may be unaware of their patient’s lack of adherence,” Ann Chen Wu, MD, MPH, of the division of general pediatrics at Boston Children’s Hospital, said in a press release. “A mismatch between parent and provider was more likely to happen if the parents felt that the medicine was not helping, or, conversely, if the parent believed their child did not need as much as prescribed.”

The researchers surveyed physicians and parents of 740 children with asthma in 2011. Parents were asked questions about their child’s asthma medicine regimen, such as “How is the child supposed to use this medicine?” Physicians were asked similar questions to assess how parental behavior was affected by physician adherence to guidelines and best practices. Other questions pertained to how often a child should take their medication, the long-term effects of medications and how medication would affect a child’s ability to participate in physical activity.

Study data showed that 72% of parents were aware of which class of controller medication their child was prescribed, and 49% knew the correct dosage frequency and the medication class. The researchers found that certain factors, however, decreased the likelihood of parents correctly identifying their child’s medication type, such as Latino parents (OR = 0.23; 95% CI, 0.057-0.9), parents who lived with a household smoker (OR = 2.87; 95% CI,0.42-19.6) and those who believed the medicine was ineffective (OR = 0.15; 95% CI, 0.048-0.45).

The researchers noted that incongruities between parent and provider reports of how frequently medications should be administered were associated with parents believing their child did not require the amount of medicine prescribed.

Wu and colleagues also stated that most physicians did not prescribe daily controller medications to children with possible persistent asthma, which they said, reflected poorly on adherence to national guidelines.

“Adherence to the guidelines has demonstrated improved outcomes: decreased hospitalizations, emergency department visits and outpatient visits,” Wu said in the release. “However, we found that half of our pediatric providers recommended seasonal, periodic or as needed use of inhaled corticosteroids which may not be in line with the guidelines.” – by David Costill

Disclosure: Wu reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.