title: Knowledge that people with intellectual disabilities have of their inhaled asthma medications: messages for pharmacists.
abstract: BACKGROUND
  Fifteen percent of Australians with intellectual disability (ID) are reported to have asthma. People with ID are at risk of poor health knowledge due to deficits in intellectual and adaptive functioning, but their medication knowledge has largely been ignored in research to date.
  
  
  OBJECTIVE
  To explore the level of understanding of asthma medication use of people with ID who self-administer their inhaled medications, in order to inform future educational support. Setting The research was conducted in NSW, Australia, at the participants' homes, the point of health care access, or the offices of relevant support organisations.
  
  
  METHODS
  In this qualitative study face-to-face interviews were conducted with people with ID using a semi-structured interview guide. The interviews were recorded, transcribed and thematically analysed. Main outcome Identification of barriers to asthma medication self-management by people with ID.
  
  
  RESULTS
  Seventeen people with ID who self-administer their asthma medications were interviewed. Factors influencing their asthma medication knowledge and use included understanding of their illness and the need for medication; aspects of self-management and autonomy versus dependence. This sample of people with ID had a good understanding of the importance of using their inhaled asthma medications, as well as asthma triggers, and the difference between use of preventer and reliever medications. Both enablers and barriers to asthma medication self-management were identified in the domains of managing attacks, adherence, knowledge of side effects and sources of information on correct use of inhalers. The level of autonomy for medication use varied, with motivation to self-manage asthma influenced by the level of support that was practically available to individual participants.
  
  
  CONCLUSIONS
  This research investigated aspects of asthma medication self-management of people with ID. Based on the barriers identified, pharmacists should promote use of spacers and written asthma action plans as well as counsel people with ID about how to recognise and minimise side effects of asthma medications. Specific strategies for pharmacists when educating people with ID and their caregivers include active listening to determine understanding of concepts, exercising care with language, and working with the person's known routines to maximise adherence with preventer medications.
authors.affiliation: Woolcock Institute of Medical Research and Discipline of Pharmacology, Sydney Medical School, The University of Sydney, PO Box M77, Missenden Rd, Camperdown, NSW, 2050, Australia. sdav2565@uni.sydney.edu.au.
authors.forename: Sharon R
authors.initials: SR
authors.lastname: Davis
authors.affiliation: Centre for Disability Studies, Sydney Medical School, University of Sydney, Camperdown, NSW, Australia.
authors.forename: Seeta
authors.initials: S
authors.lastname: Durvasula
authors.affiliation: Synergy Medical Practice, Greenwich, NSW, Australia.
authors.forename: Diana
authors.initials: D
authors.lastname: Merhi
authors.affiliation: Woolcock Institute of Medical Research and Discipline of Pharmacology, Sydney Medical School, The University of Sydney, PO Box M77, Missenden Rd, Camperdown, NSW, 2050, Australia.
authors.forename: Paul M
authors.initials: PM
authors.lastname: Young
authors.affiliation: Woolcock Institute of Medical Research and Discipline of Pharmacology, Sydney Medical School, The University of Sydney, PO Box M77, Missenden Rd, Camperdown, NSW, 2050, Australia.
authors.forename: Daniela
authors.initials: D
authors.lastname: Traini
authors.affiliation: Woolcock Institute of Medical Research and Discipline of Pharmacology, Sydney Medical School, The University of Sydney, PO Box M77, Missenden Rd, Camperdown, NSW, 2050, Australia.|Sydney Local Health District, Sydney, NSW, Australia.
authors.forename: Sinthia Z
authors.initials: SZ
authors.lastname: Bosnic Anticevich
mesh_terms: D000280:Administration, Inhalation; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D001249:Asthma / Q000188:drug therapy* / Q000503:physiopathology / Q000523:psychology; D003157:Community Pharmacy Services; D032882:Comprehension; D003695:Delivery of Health Care; D007722:Health Knowledge, Attitudes, Practice; D057220:Health Literacy; D006801:Humans; D008607:Intellectual Disability / Q000523:psychology*; D007407:Interviews as Topic; D055118:Medication Adherence; D009517:New South Wales; D026684:Personal Autonomy; D019989:Persons with Intellectual Disabilities / Q000523:psychology*; D010595:Pharmacists; D024382:Professional Role; D036301:Qualitative Research; D012646:Self Administration
chemical_list: D018927:Anti-Asthmatic Agents
keywords: Asthma; Caregivers; Inhaler; Intellectual disability; Interviews; Pharmacists; Qualitative research; Self-management