Objective: Clinical practice guidelines recommend that physicians provide asthma education to patients and their families. To characterize parents' and children's perception of physician practice, we examined: (i) proportion of parents and children reporting physician discussion of asthma education topics; (ii) age-group differences in children's report; (iii) site differences in children's and parents' report; (iv) sociodemographic and disease characteristics associated with children's report; and (v) the relation between children's report and adherence to daily controller medications.
Methods: We conducted a cross-sectional study of 125 children with asthma (mean age = 11.3 years; 62% were male) and their parents. Parents provided demographic and disease data. Children reported whether physicians had ever discussed each of 16 asthma education topics with them. We used logistic regression to examine age-group and site differences in children's report of physician discussion of each topic. Multivariate linear regression was used to determine associations between demographic (e.g., child age, race) and disease (e.g., symptom severity) variables and topics discussed.
Results: On average, 34.7% of children reported physician discussion of a topic; 8-10-year-olds reported significantly fewer topics discussed than children aged 11 and older (p < .05). Whereas parents' report differed by practice setting, children's report did not. In multivariate analyses, child age (β = 0.46 (SE: 0.17); p < .01), persistent symptoms (β = 1.59 (SE: 0.80); p < .05), and number of outpatient asthma visits (β = 0.19 (SE: 0.08); p < .05) remained significantly associated with number of topics discussed.
Conclusion: These results suggest that the majority of children either may not receive, or may not recall receiving, information from their physicians about the fundamentals of asthma management. Physicians have an invaluable teaching opportunity in the medical office visit and should consider capitalizing on this opportunity to build children's sense of self-efficacy and competence in their self-care.