Frey Sean M, Fagnano Maria, Halterman Jill
Department of Pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, NY.
Department of Pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, NY.
Acad Pediatr. 2016 Nov-Dec;16(8):799-805. doi: 10.1016/j.acap.2016.04.005. Epub 2016 Apr 26.
To determine caregiver ability to name their child's inhaled asthma medications, and examine whether perceived ease of remembering names is associated with accurate naming and asthma outcomes.
As part of the School-Based Telemedicine-Enhanced Asthma Management trial in Rochester, New York, we asked caregivers of children with persistent asthma to: 1) name their child's inhaled medications, and 2) indicate agreement with the statement, "it is easy to remember the names of my child's asthma medications." We limited analyses to subjects with 1 inhaled medication. Reported names were compared with canisters available during a home visit; complete matches were considered concordant. We compared ease of remembering names with concordance, asthma symptoms, and adherence using bivariate and multivariate analyses.
Overall, 141 caregivers (87%) had children with 1 inhaled medication (62% black race, 68% Medicaid). Most (74%) perceived it easy to remember medication names, yet only 46% reported names concordant with medications at home. Caregivers who did not easily remember medication names were less likely to concordantly name available medications (23% vs 54%; P = .002), and more likely to report that their child experienced >2 symptom days per week (33% vs 16%; P = .03), >2 symptom nights per month (31% vs 12%; P = .02), and missed >1 dose(s) of preventive medication in the previous 2 weeks (52% vs 28%; P = .03). Findings were consistent in multivariate regression analyses.
Caregivers of urban children with persistent asthma who considered medication names difficult to remember were less able to accurately name available medications, and reported worse control and medication adherence. Greater attention to medication identification might improve outcomes in this population.
确定照顾者说出其孩子吸入性哮喘药物名称的能力,并研究感知到的记忆药物名称的难易程度是否与准确说出药物名称及哮喘治疗结果相关。
作为纽约罗切斯特市基于学校的远程医疗强化哮喘管理试验的一部分,我们要求患有持续性哮喘儿童的照顾者:1)说出其孩子的吸入药物名称;2)表明是否同意“记住我孩子哮喘药物的名称很容易”这一说法。我们将分析限于使用1种吸入药物的受试者。将报告的药物名称与家访时提供的药罐进行比较;完全匹配视为一致。我们使用双变量和多变量分析比较了记忆药物名称的难易程度与一致性、哮喘症状及依从性之间的关系。
总体而言,141名照顾者(87%)的孩子使用1种吸入药物(62%为黑人,68%参加医疗补助计划)。大多数(74%)认为记住药物名称很容易,但只有46%报告的药物名称与家中药物一致。不容易记住药物名称的照顾者准确说出可用药物名称的可能性较小(23%对54%;P = 0.002),更有可能报告其孩子每周出现症状的天数超过2天(33%对16%;P = 0.03),每月出现症状的夜晚超过2个(31%对12%;P = 0.02),以及在前两周内错过超过1剂预防性药物(52%对28%;P = 0.03)。多变量回归分析的结果一致。
认为药物名称难以记住的城市持续性哮喘儿童的照顾者准确说出可用药物名称的能力较差,且报告的病情控制和药物依从性较差。更加关注药物识别可能会改善该人群的治疗结果。