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Patient Educ Couns. 2008 Mar;70(3):376-85. Epub 2007 Dec 26.

Patterns of concordance and non-concordance with clinician recommendations and parents' explanatory models in children with asthma.

Author information

1
Center for Health Quality, Outcomes and Economic Research, ENRM Veterans Affairs Medical Center,Bedford, MA 01742, United States. bokhour@bu.edu

Abstract

OBJECTIVE:

Many children with asthma do not take medications as prescribed. We studied parents of children with asthma to define patterns of non-concordance between families' use of asthma controller medications and clinicians' recommendations, examine parents' explanatory models (EMs) of asthma, and describe relationships between patterns of non-concordance and EM.

METHODS:

Qualitative study using semi-structured interviews with parents of children with persistent asthma. Grounded theory analysis identified recurrent themes and relationships between reported medication use, EMs, and other factors.

RESULTS:

Twelve of the 37 parents reported non-concordance with providers' recommendations. Three types of non-concordance were identified: unintentional--parents believed they were following recommendations; unplanned--parents reported intending to give controller medications but could not; and intentional--parents stated giving medication was the wrong course of action. Analysis revealed two EMs of asthma: chronic--parents believed their child always has asthma; and intermittent--parents believed asthma was a problem their child sometimes developed.

CONCLUSIONS:

Concordance or non-concordance with recommended use of medications were related to EM's and family context and took on three different patterns associated with medication underuse.

PRACTICE IMPLICATIONS:

Efforts to reduce medication underuse in children with asthma may be optimized by identifying different types of non-concordance and tailoring interventions accordingly.

PMID:
18162357
PMCID:
PMC2376053
DOI:
10.1016/j.pec.2007.11.007
[Indexed for MEDLINE]
Free PMC Article
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