Parental Asthma Education and Risks for Nonadherence to Pediatric Asthma Treatments

• Authors: Eva M. Delgado, Childrens Hospital of Philadelphia; Christine S. Cho, University of California San Francisco; Ginny Gildengorin, Children's Hospital Oakland; Sara A. Leibovich, Children's Hospital Oakland Research Institute; Claudia R. Morris, Emory University
• Journal Title: Pediatric Emergency Care
• Volume: Volume 30, Number 11
• Publisher: Lippincott, Williams & Wilkins | 2014-11-01, Pages 782-787
• Type of Work: Article | Post-print: After Peer Review
• Publisher DOI: http://doi.org/10.1097/PEC.0000000000000259
• Subjects: Health Sciences, Health Care Management
• Keywords: Science & Technology; Life Sciences & Biomedicine; Emergency Medicine; Pediatrics; asthma; medication nonadherence; minority health; education; INNER-CITY CHILDREN; CARE MEASURES; ADHERENCE; LITERACY; INTERPRETERS; PROFICIENCY; MORBIDITY; KNOWLEDGE; OUTCOMES

Abstract

OBJECTIVES: Targeted parental education reduces acute visits for pediatric asthma. Whether the use of education sources readily available to parents relates to nonadherence to asthma treatments is uncertain. This study describes asthma education sources and assesses for a relationship to risks for nonadherence. METHODS: Caregivers of children with asthma completed a cross-sectional survey at 2 sites: a pediatric emergency department (ED) and an asthma clinic (AC). Measured items included the use of 7 education sources (primary care, ED, AC, friends/family, TV, internet, and printed materials), scores of child asthma morbidity, parental asthma knowledge, and risks for nonadherence, the primary outcome. Recruitment site, preferred language (English/Spanish), and demographics were recorded. Descriptive statistics, bivariate analyses, and multivariate regressions were performed. RESULTS: A total of 260 participants, 158 from ED and 102 from AC, used a variety of education sources. They reported 4.1 (2.0) of 13 risk factors for nonadherence, with more risks in ED parents than AC parents (4.8 vs 3.9, P < 0.001). The ED parents worried more about medications and had worse access to primary care. The regression did not show a significant relationship between education sources and risks for nonadherence, but ED recruitment, Spanish language, and worse morbidity contributed to higher risks. CONCLUSIONS: The use of more asthma education sources was not associated with reduced risks for nonadherence. Of the education sources, a primary care provider may benefit ED parents, who also need refills and education about medications. Spanish-speaking parents report more risks for nonadherence, warranting further study of Spanish-language asthma education.