Effect of an Asthma Question Prompt List and Video Intervention on Adolescents' Medication Adherence 12 Months Later

Ann Pharmacother. 2019 Jul;53(7):683-689. doi: 10.1177/1060028019831259. Epub 2019 Feb 13.

Abstract

Background: Many adolescents do not obtain the maximum benefit from their asthma medications. Improving patient-provider communication may improve adolescents' asthma knowledge, adherence, and clinical outcomes.

Objective: To determine how a question prompt list and educational video intervention affect youth- and caregiver-reported medication adherence and self-reported medication problems.

Methods: Adolescents with persistent asthma (n = 359; 56.4% with moderate to severe asthma) and their caregivers were enrolled in a randomized controlled trial at 4 pediatric clinics. Intervention group families received a question prompt list and watched a short video before seeing the provider; control families received usual care. Youth- and caregiver-reported medication adherence was measured with a Visual Analog Scale, ranging from 0 to 100. Generalized estimating equations were used to determine how the intervention and covariates were associated with medication adherence and reported problems at 12 months.

Results: The intervention was not a significant predictor of medication adherence at 12 months. Higher caregiver education was associated with higher youth-reported adherence (β = 1.1; 95% CI = 0.1, 2.1; P = 0.036) and caregiver-reported adherence (β = 1.2; 95% CI = 0.3, 2.0; P = 0.006). The intervention was associated with fewer caregiver-reported problems at 12 months (β = -0.32; 95% CI = -0.48, -0.16; P < 0.001).

Conclusions and relevance: A question prompt list and educational video decreased the number of caregiver-reported medication problems, but did not significantly affect medication adherence. Further research is needed to develop more effective interventions to improve medication adherence and outcomes.

Keywords: medication adherence; medication problems; patient education; patient-provider communication.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Anti-Asthmatic Agents / administration & dosage
  • Anti-Asthmatic Agents / therapeutic use*
  • Asthma / drug therapy*
  • Caregivers
  • Child
  • Drug Monitoring*
  • Female
  • Humans
  • Patient Education as Topic / methods*
  • Patient Education as Topic / statistics & numerical data
  • Self Report
  • Surveys and Questionnaires
  • Therapy, Computer-Assisted / methods*
  • Therapy, Computer-Assisted / statistics & numerical data
  • Webcasts as Topic*

Substances

  • Anti-Asthmatic Agents