title: Changes in clinical conversations when providers are informed of asthma patients' beliefs about medication use and integrative medical therapies.
abstract: OBJECTIVE
  To explore whether patient's personal beliefs about inhaled corticosteroid (ICS) and integrative medicine (IM) are discussed at routine primary care visits for asthma.
  
  
  BACKGROUND
  Negative medication beliefs and preferences for IM can be salient barriers to effective asthma self-management.
  
  
  METHODS
  A qualitative analysis of transcripts from 33 audio-recorded primary care visits using conventional content analysis techniques.
  
  
  RESULTS
  Four themes emerged when providers had knowledge of patient's beliefs: negative ICS beliefs, IM use for asthma, decision-making and healthy lifestyles. Two themes were identified when providers did not have this knowledge: asthma self-management and healthy lifestyles.
  
  
  CONCLUSIONS
  When providers had knowledge of their patient's IM endorsement or negative ICS beliefs, they initiated conversations about these modifiable beliefs. Without training in IM and in effective communication techniques, it is unlikely that providers will be able to effectively engage in shared decision-making aimed at improving asthma self-management.
authors.affiliation: Columbia University School of Nursing, USA. Electronic address: mg3656@cumc.columbia.edu.
authors.forename: Maureen
authors.initials: M
authors.lastname: George
authors.affiliation: University of Pennsylvania School of Nursing, USA.
authors.forename: Sarah
authors.initials: S
authors.lastname: Abboud
authors.affiliation: Department of Psychiatry, School of Medicine, Yale University, USA; Department of Emergency Medicine, School of Medicine, Yale University, USA.
authors.forename: Michael V
authors.initials: MV
authors.lastname: Pantalon
authors.affiliation: University of Pennsylvania School of Nursing, USA.
authors.forename: Marilyn Lynn S
authors.initials: ML
authors.lastname: Sommers
authors.affiliation: University of Pennsylvania, Perelman School of Medicine, USA.
authors.forename: Jun
authors.initials: J
authors.lastname: Mao
authors.affiliation: Johns Hopkins University School of Medicine, USA.
authors.forename: Cynthia
authors.initials: C
authors.lastname: Rand
mesh_terms: D000280:Administration, Inhalation; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage* / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D001249:Asthma / Q000188:drug therapy*; D003142:Communication; D003657:Decision Making; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012648:Self Care / Q000379:methods
chemical_list: D000305:Adrenal Cortex Hormones
keywords: Asthma; Decision-making; Health beliefs; Integrative medicine; Patient-provider communication; Primary care