Caregiver education to promote appropriate use of preventive asthma medications: what is happening in primary care?

Abstract

Objective To describe actions taken by providers at primary care visits to promote daily use of preventive asthma medication, and determine whether patient or encounter variables are associated with the receipt of asthma medication education. Methods As part of a larger study in Rochester, NY, caregivers of children (2 to 12 years old) with asthma were approached before an office visit for well-child, asthma-specific, or other illness care from October 2009 to January 2013. Eligibility required persistent symptoms and a prescription for an inhaled asthma controller medication. Caregivers were interviewed within 2 weeks to discuss the health care encounter. Results We identified 185 eligible children from 6 urban primary care offices (27% Black, 38% Hispanic, 65% Medicaid). Overall, 42% of caregivers reported a discussion of appropriate preventive medication use, fewer than 25% received an asthma action plan, and 17% reported ‘ideal’ medication education (both discussing proper medication use and completing an asthma action plan); no differences were seen upon comparing well-child and asthma-specific visits with other visits. Well-child and asthma-specific visits together were more likely, compared with other visits, to include a recommendation for a follow-up visit (43% vs 23%, p = 0.007). No patient factors were associated with report of preventive medication education. Conclusions Guideline-recommended education for caregivers about preventive asthma medication is not occurring in the majority of primary care visits for urban children with symptomatic persistent asthma. Novel methods to deliver asthma education may be needed to promote appropriate preventive medication use and reduce asthma morbidity.

Well-Child Care Attendance and Risk of Asthma Exacerbations

“…A number of studies have revealed that WCC visits are key to introducing asthma education and for supporting best practices. [16][17][18] Regular assessments of asthma control in a nonemergency setting have a significant impact on asthma control. 19,20 In expert guidelines, it is recommended that children with asthma receive regular monitoring at least every 6 months.…”

Evaluating the implementation of a multicomponent asthma education program for Head Start staff

“…Child care providers for preschoolers have been shown to have positive attitudes toward having children with asthma in their classrooms but lack confidence and resources to evaluate and treat asthma symptoms (11). Traditional models of educating parents of children with asthma have focused on the role of healthcare providers in the education delivery process; however, multiple research studies have shown that this is inadequate, particularly for low-income urban families (23). Additionally, this traditional model also assumes that either the parent or healthcare provider will provide the school with the necessary knowledge and skills to manage asthma.…”

Effect of family caregiver nursing education on patients with rheumatoid arthritis and its impact factors: A randomized controlled trial

“…Nursing education for family caregivers is considered as a workable and effective intervention that directly improves their disease knowledge, physiological management abilities and psychological support skills to provide better care to patients[ 8 ]. Studies have shown this intervention plays an active role in the course of specific diseases including stroke[ 9 ], asthma[ 10 ] and kidney injury[ 11 ]. However, the effectiveness of care education for family caregivers of patients with RA has not been reported.…”