| Influence of caregiver and provider communication on symptom days and medication use for inner-city children with asthma. | |
| | |
MedLine Citation:
|
PMID: 20528605 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: Effective pediatric guideline-based asthma care requires the caregiver to accurately relay the child's symptom frequency, pattern of rescue and controller medication use, and level of asthma control to the child's primary care clinician. OBJECTIVE: This study evaluated the longitudinal effects of a caregiver-clinician asthma communication education intervention (ACE) relative to an asthma education control group (CON) on symptom days and controller medication use in inner-city children with asthma. Participants and METHODS: 231 inner-city children with asthma, recruited from urban pediatric emergency departments (EDs) and community practices, were followed for 12 months. Data included number of symptom days and nights, ED visits, hospitalizations, presence of limited activity, and controller medication use over 12 months. Pharmacy records were used to calculate controller to total asthma medication ratios as a proxy of appropriate controller medication use. Multivariate logistic regression models were used to identify factors associated with number of symptom days and nights over the past 30 days at the 12-month follow-up. RESULTS: Most caregivers rated the communication with their child's clinician as high. Unadjusted and adjusted rates of symptom days and nights did not differ by group at follow-up. ACE children tended towards a higher controller to total medication ratio at 12 months as compared to CON children (mean ratio: ACE: 0.54, SD 0.3; CON, 0.45, SD 0.4; p = .07). Activity limitation due to asthma and persistent asthma severity were the only factors significantly associated with reporting any symptom day within the past 30 days, adjusting for treatment group, number of oral corticosteroid courses and number of clinician visits in the last 6 months, seasonality, insurance type, and controller to total asthma medication ratio covariates. CONCLUSION: A home-based caregiver asthma communication educational intervention was not associated with decreased symptom days. However, a trend was noted in higher controller to total medication ratios in the intervention group. Inner-city caregivers of children with asthma may require a health systems approach to help convey the child's asthma health information to their clinician. |
| | |
Authors:
|
Arlene Butz; Joan Kub; Michele Donithan; Nathan T James; Richard E Thompson; Melissa Bellin; Mona Tsoukleris; Mary Elizabeth Bollinger |
Related Documents
:
|
10678245 - Excessive use of inhaled salbutamol: the potential benefits of dose-reduction. a case r... 11003425 - Pathogenesis and current management of gastrooesophageal-reflux-related asthma. 9250885 - Ozone as a bioregulator. pharmacology and toxicology of ozonetherapy today. 19173785 - Allergen immunotherapy and asthma: efficacy, safety, and other considerations. 2252925 - Are readmissions avoidable? 16184015 - Taking a medical history in childhood illness: representations of parents in pediatric ... |
Publication Detail:
|
Type: Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural |
Journal Detail:
|
Title: The Journal of asthma : official journal of the Association for the Care of Asthma Volume: 47 ISSN: 1532-4303 ISO Abbreviation: J Asthma Publication Date: 2010 May |
Date Detail:
|
Created Date: 2010-06-10 Completed Date: 2010-06-30 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 8106454 Medline TA: J Asthma Country: England |
Other Details:
|
Languages: eng Pagination: 478-85 Citation Subset: IM |
Affiliation:
|
School of Medicine, Department of Pediatrics, The Johns Hopkins University, Baltimore, Maryland 21287, USA. abutz@jhmi.edu |
| Data Bank Information | |
Bank Name/Acc. No.:
|
ClinicalTrials.gov/NCT00133666 |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
African Americans
/
statistics & numerical data Anti-Asthmatic Agents / therapeutic use Asthma / ethnology, therapy* Caregivers* Child Drug Utilization Emergency Service, Hospital / statistics & numerical data Female Health Education / methods* Health Personnel Hospitalization / statistics & numerical data Humans Logistic Models Longitudinal Studies Male Medical Assistance / statistics & numerical data Professional-Family Relations* Severity of Illness Index Urban Population / statistics & numerical data* |
| Grant Support | |
ID/Acronym/Agency:
|
NR008544/NR/NINR NIH HHS |
| Chemical | |
Reg. No./Substance:
|
0/Anti-Asthmatic Agents |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Frequent ear infections in infancy and the risk of asthma in mexican american children.
Next Document: Deterioration of Asthma in a Patient With Diffuse Panbronchiolitis (DPB) After Macrolide Therapy.