The Effect of Risk, Side Effect, and Benefit Communication in Pediatric Asthma Visits on Asthma Control Medication Adherence, Caregiver- and Child-Reported Problems/Concerns About Side Effects

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  • March 22, 2019
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  • Gillette, Christopher
    • Affiliation: Eshelman School of Pharmacy, Division of Pharmaceutical Outcomes and Policy
Abstract
  • A secondary analysis was conducted on child interview, caregiver questionnaire, and transcripts of audiotaped medical visit data collected in North Carolina clinics from 2005-2009. The data includes 35 providers and 295 children with persistent asthma. Qualitative analyses examined the content of control medication side effect, risk, and benefit discussions. Generalized estimating equations were used to predict side effect, risk, and benefit discussions, medication adherence, and concerns about side effects. Results revealed that 4% of visits included side effect discussions. Side effect discussions were more likely with younger children. Sixteen percent of visits included risk discussions. Risks were more likely to be discussed when children were taking/prescribed an inhaled corticosteroid and during longer visits. Approximately 47% of visits included benefit discussions. Benefits were more likely to be discussed when: the child was younger; the child was taking/prescribed an inhaled corticosteroid; and adherence was discussed. Average medication adherence was 85%. Caregivers were more likely to report the child as 80% or more adherent when the: child took more control medications, visit was longer, and the child had seen the provider more. Discussions of medication risks were not associated with control medication adherence of at least 80%, contrary to our hypothesis. Approximately 37% of caregivers reported a concern about side effects. Caregivers were more likely to report a concern when the child had seen the provider less. Discussions of risks were not associated with caregivers reporting a problem/concern about side effects, contrary to our hypothesis. Approximately 33% of children reported a concern about side effects. Children were more likely to report a concern about side effects when the: caregiver was not married, child did not take an inhaled corticosteroid, and they saw male providers. Discussions of side effects and benefits were not associated with the child reporting a concern, contrary to the hypotheses. Study results showed that discussions of medication benefits were more frequent than discussions of side effects and risks, although less than half of visits had benefit discussions. Future research should investigate how to improve communication in these areas.
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  • ... in partial fulfillment of the requirements for the degree of Doctor of Philosophy in the Division of Pharmaceutical Outcomes and Policy.
Advisor
  • Sleath, Betsy
Degree granting institution
  • University of North Carolina at Chapel Hill
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