ABSTRACT
Children with asthma are exposed to antibiotics more frequently than their peers. The quality of provider-patient discussion about antibiotics is unknown. In this secondary data analysis, we reviewed existing transcripts of audiotaped adolescent asthma visits using a standardized coding sheet to analyze the quality of communication about antibiotics. Of 539 transcripts, we identified 12 discussions about antibiotics. No patient or parent requested antibiotics. In most cases, discussion was limited to assessment of drug allergies and preferred formulation. In 5 cases (42%), the prescribed antibiotic was not named. We propose a set of communication elements that should be included whenever antibiotics are prescribed, classified into ( a) Essential, such as the drug name and dosing schedule; ( b) Encouraged, such as expected response to therapy; or ( c) Situational, such as discussion of alternatives to antibiotics. Future research should further explore the quality of antibiotic-related conversations among different groups of providers and patients.
Subject(s)
Anti-Bacterial Agents/therapeutic use , Asthma/drug therapy , Inappropriate Prescribing/statistics & numerical data , Patient Education as Topic/statistics & numerical data , Physician-Patient Relations , Practice Patterns, Physicians'/statistics & numerical data , Professional-Family Relations , Adolescent , Child , Directive Counseling/statistics & numerical data , Female , Follow-Up Studies , Humans , Male , Observer Variation , Pediatrics , Primary Health CareABSTRACT
Little is known about factors associated with the receipt of medication information among arthritis patients. This study explores information source receipt and associations between demographic and clinical/patient characteristics and the amount of arthritis medication information patients receive. Adult patients with osteoarthritis (OA) or rheumatoid arthritis (RA; n = 328) completed an online cross-sectional survey. Patients reported demographic and clinical/patient characteristics and the amount of arthritis medication information received from 15 information sources. Bivariate and multivariate linear regression analyses were used to investigate whether those characteristics were associated with the amount of medication information patients received. Arthritis patients received the most information from health professionals, followed by printed materials, media sources, and interpersonal sources. Greater receipt of information was associated with greater medication adherence, taking more medications, greater medication-taking concerns, more satisfaction with doctor medication-related support, and Black compared to White race. RA patients reported receiving more information compared to OA patients, and differences were found between RA patients and OA patients in characteristics associated with more information receipt. In conclusion, arthritis patients received the most medication information from professional sources, and both positive (e.g., greater satisfaction with doctor support) and negative (e.g., more medication-taking concerns) characteristics were associated with receiving more medication information.
Subject(s)
Arthritis, Rheumatoid/drug therapy , Osteoarthritis/drug therapy , Patient Education as Topic/statistics & numerical data , Adolescent , Adult , Aged , Antirheumatic Agents/therapeutic use , Cross-Sectional Studies , Female , Humans , Linear Models , Male , Middle Aged , Young AdultABSTRACT
OBJECTIVE: Examine correlates of asthma self-management among 12,154 adolescents with physician-diagnosed asthma. METHODS: All 7th and 8th grade students in North Carolina completed a survey to assess asthma prevalence and self-management behaviors among those with asthma. RESULTS: Adolescents who were allowed to carry their inhaled medication at school, shown how to use a peak flow meter, and had access to more asthma care resources were more confident that they could prevent an asthma exacerbation. Adolescents who were allowed to carry their inhaled medication at school and who had a private doctor were more confident that they could control their symptoms. Adolescents taking anti-inflammatory medicine were less confident that they could prevent an exacerbation and control their symptoms. CONCLUSIONS: Various indicators of autonomy and control were associated with greater self-efficacy for managing asthma. Adolescents who require anti-inflammatory medicines would benefit from additional intervention efforts to improve their asthma management self-efficacy.
