儿科哮喘就诊期间的沟通和自我报告的哮喘药物依从性。
Communication during pediatric asthma visits and self-reported asthma medication adherence.
机构信息
Division of Pharmaceutical Outcomes and Policy, University of North Carolina at Chapel Hill, Beard Hall, CB# 7360, Chapel Hill, NC 27599-7360, USA.
出版信息
Pediatrics. 2012 Oct;130(4):627-33. doi: 10.1542/peds.2012-0913. Epub 2012 Sep 3.
OBJECTIVE
Our objectives were to examine how certain aspects of provider-patient communication recommended by national asthma guidelines (ie, provider asking for child and caregiver input into the asthma treatment plan) were associated with child asthma medication adherence 1 month after an audio-taped medical visit.
METHODS
Children ages 8 through 16 with mild, moderate, or severe persistent asthma and their caregivers were recruited at 5 pediatric practices in nonurban areas of North Carolina. All medical visits were audio-tape recorded. Children were interviewed 1 month after their medical visits, and both children and caregivers reported the child's control medication adherence. Generalized estimating equations were used to determine if communication during the medical visit was associated with medication adherence 1 month later.
RESULTS
Children (n = 259) completed a home visit interview ∼1 month after their audio-taped visit, and 216 of these children were taking an asthma control medication at the time of the home visit. Children reported an average control medication adherence for the past week of 72%, whereas caregivers reported the child's average control medication adherence for the past week was 85%. Child asthma management self-efficacy was significantly associated with both child- and caregiver-reported control medication adherence. When providers asked for caregiver input into the asthma treatment plan, caregivers reported significantly higher child medication adherence 1 month later.
CONCLUSIONS
Providers should ask for caregiver input into their child's asthma treatment plan because it may lead to better control medication adherence.
目的
我们的目的是研究国家哮喘指南推荐的某些医患沟通方面（即，医生询问患儿及其照顾者对哮喘治疗计划的意见）如何与患儿在接受录音医疗访问后 1 个月的哮喘药物依从性相关。
方法
在北卡罗来纳州非城市地区的 5 家儿科诊所招募了 8 至 16 岁患有轻度、中度或重度持续性哮喘的儿童及其照顾者。所有医疗访问均进行录音。在医疗访问后 1 个月对患儿进行访谈，患儿及其照顾者报告了患儿的控制药物依从性。使用广义估计方程来确定医疗访问期间的沟通是否与 1 个月后的药物依从性相关。
结果
（n=259）名儿童在接受录音医疗访问后约 1 个月完成了家庭访问访谈，其中 216 名儿童在家庭访问时正在服用哮喘控制药物。儿童报告过去一周平均控制药物依从率为 72%，而照顾者报告过去一周儿童平均控制药物依从率为 85%。患儿哮喘管理自我效能感与患儿和照顾者报告的控制药物依从性均显著相关。当医生向照顾者询问其对哮喘治疗计划的意见时，照顾者报告患儿 1 个月后药物依从性显著提高。
结论
医生应该向照顾者询问其对患儿哮喘治疗计划的意见，因为这可能会导致更好的控制药物依从性。
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