OBJECTIVE: Many children with asthma do not take medications as prescribed. We studied parents of children with asthma to define patterns of non-concordance between families' use of asthma controller medications and clinicians' recommendations, examine parents' explanatory models (EMs) of asthma, and describe relationships between patterns of non-concordance and EM. METHODS: Qualitative study using semi-structured interviews with parents of children with persistent asthma. Grounded theory analysis identified recurrent themes and relationships between reported medication use, EMs, and other factors. RESULTS: Twelve of the 37 parents reported non-concordance with providers' recommendations. Three types of non-concordance were identified: unintentional--parents believed they were following recommendations; unplanned--parents reported intending to give controller medications but could not; and intentional--parents stated giving medication was the wrong course of action. Analysis revealed two EMs of asthma: chronic--parents believed their child always has asthma; and intermittent--parents believed asthma was a problem their child sometimes developed. CONCLUSIONS: Concordance or non-concordance with recommended use of medications were related to EM's and family context and took on three different patterns associated with medication underuse. PRACTICE IMPLICATIONS: Efforts to reduce medication underuse in children with asthma may be optimized by identifying different types of non-concordance and tailoring interventions accordingly.
OBJECTIVE: Many children with asthma do not take medications as prescribed. We studied parents of children with asthma to define patterns of non-concordance between families' use of asthma controller medications and clinicians' recommendations, examine parents' explanatory models (EMs) of asthma, and describe relationships between patterns of non-concordance and EM. METHODS: Qualitative study using semi-structured interviews with parents of children with persistent asthma. Grounded theory analysis identified recurrent themes and relationships between reported medication use, EMs, and other factors. RESULTS: Twelve of the 37 parents reported non-concordance with providers' recommendations. Three types of non-concordance were identified: unintentional--parents believed they were following recommendations; unplanned--parents reported intending to give controller medications but could not; and intentional--parents stated giving medication was the wrong course of action. Analysis revealed two EMs of asthma: chronic--parents believed their child always has asthma; and intermittent--parents believed asthma was a problem their child sometimes developed. CONCLUSIONS: Concordance or non-concordance with recommended use of medications were related to EM's and family context and took on three different patterns associated with medication underuse. PRACTICE IMPLICATIONS: Efforts to reduce medication underuse in children with asthma may be optimized by identifying different types of non-concordance and tailoring interventions accordingly.
Authors: Stanley Szefler; Scott Weiss; James Tonascia; N Franklin Adkinson; Bruce Bender; Reuben Cherniack; Michele Donithan; H William Kelly; Joseph Reisman; Gail G Shapiro; Alice L Sternberg; Robert Strunk; Virginia Taggart; Mark Van Natta; Robert Wise; Margaret Wu; Robert Zeiger Journal: N Engl J Med Date: 2000-10-12 Impact factor: 91.245
Authors: Tracy A Lieu; Paula Lozano; Jonathan A Finkelstein; Felicia W Chi; Nancy G Jensvold; Angela M Capra; Charles P Quesenberry; Joe V Selby; Harold J Farber Journal: Pediatrics Date: 2002-05 Impact factor: 7.124
Authors: Laurie J Bauman; Elizabeth Wright; Frederick E Leickly; Ellen Crain; Deanna Kruszon-Moran; Shari L Wade; Cynthia M Visness Journal: Pediatrics Date: 2002-07 Impact factor: 7.124
Authors: Lindsay N Fuzzell; A Scott LaJoie; Kyle T Smith; Sydney E Philpott; Katherine M Jones; Mary C Politi Journal: Patient Educ Couns Date: 2018-05-01
Authors: Christine M Gunn; Barbara Bokhour; Victoria A Parker; Patricia A Parker; Sarah Blakeslee; Hanna Bandos; Christine Holmberg Journal: Cancer Nurs Date: 2019 Jan/Feb Impact factor: 2.592
Authors: Michelle N Eakin; Cynthia S Rand; Andrew Bilderback; Mary E Bollinger; Arlene Butz; Veni Kandasamy; Kristin A Riekert Journal: J Allergy Clin Immunol Date: 2011-11-21 Impact factor: 10.793
Authors: Barbara G Bokhour; Ellen S Cohn; Dharma E Cortés; Jeffrey L Solomon; Gemmae M Fix; A Rani Elwy; Nora Mueller; Lois A Katz; Paul Haidet; Alexander R Green; Ann M Borzecki; Nancy R Kressin Journal: J Gen Intern Med Date: 2012-07-21 Impact factor: 5.128
Authors: Mira G P Zuidgeest; Liset van Dijk; Peter Spreeuwenberg; Henriëtte A Smit; Bert Brunekreef; Hubertus G M Arets; Madelon Bracke; Hubert G M Leufkens Journal: Ann Fam Med Date: 2009 Jan-Feb Impact factor: 5.166