title: Communication during pediatric asthma visits and child asthma medication device technique 1 month later.
abstract: OBJECTIVE
  This study investigated how provider demonstration of and assessment of child use of asthma medication devices and certain aspects of provider-patient communication during medical visits is associated with device technique 1 month later.
  
  
  METHODS
  Two hundred and ninety-six children aged 8-16 years with persistent asthma and their caregivers were recruited at five North Carolina pediatric practices. All of the medical visits were audio-tape recorded. Children were interviewed 1 month later and their device technique was observed and rated.
  
  
  RESULTS
  If the provider asked the child to demonstrate metered dose inhaler technique during the medical visit, then the child was significantly more likely to perform a greater percentage of inhaler steps correctly 1 month later. Children with higher asthma management self-efficacy scores were significantly more likely to perform a greater percentage of diskus steps correctly. Additionally, children were significantly more likely to perform a greater percentage of diskus steps correctly if the provider discussed a written action plan during the visit. Children were significantly more likely to perform a greater percentage of turbuhaler steps correctly if they asked more medication questions.
  
  
  CONCLUSIONS
  Providers should ask children to demonstrate their inhaler technique during medical visits so that they can educate children about proper technique and improve child asthma management self-efficacy. Providers should encourage children to ask questions about asthma medication devices during visits and they should discuss asthma action plans with families.
authors.affiliation: Division of Pharmaceutical Outcomes and Policy, University of North Carolina Eshelman School of Pharmacy, Chapel Hill, 27599-7573, USA. betsy_sleath@unc.edu
authors.forename: Betsy
authors.initials: B
authors.lastname: Sleath
authors.forename: Delesha M
authors.initials: DM
authors.lastname: Carpenter
authors.forename: Guadalupe X
authors.initials: GX
authors.lastname: Ayala
authors.forename: Dennis
authors.initials: D
authors.lastname: Williams
authors.forename: Stephanie
authors.initials: S
authors.lastname: Davis
authors.forename: Gail
authors.initials: G
authors.lastname: Tudor
authors.forename: Karin
authors.initials: K
authors.lastname: Yeatts
authors.forename: Chris
authors.initials: C
authors.lastname: Gillette
mesh_terms: D000280:Administration, Inhalation; D000293:Adolescent; D000367:Age Factors; D001249:Asthma / Q000628:therapy*; D002648:Child; D003142:Communication; D005260:Female; D006801:Humans; D008297:Male; D009330:Nebulizers and Vaporizers; D015588:Observer Variation; D010353:Patient Education as Topic / Q000379:methods*; D020377:Self Efficacy; D012720:Severity of Illness Index; D012737:Sex Factors; D012959:Socioeconomic Factors