Factors affecting pharmacists' pediatric asthma counseling

Objective: To explore various factors that may influence community pharmacists' pediatric asthma counseling. Design: Cross-sectional. Setting: Maryland from September 2002 through March 2003. Participants: Random sample of 400 community pharmacists. Intervention: Mail survey. Main outcome measures: Pharmacists' attitude, subjective norm, perceived behavioral control, intention to provide pediatric asthma counseling, and reported counseling using the theory of planned behavior as a framework; demographic and pharmacy characteristics. Results: 98 of 389 (25%) eligible pharmacists responded. Most acknowledged the importance of providing asthma counseling to children (54%) or caregivers (68%). However, only a small number reported demonstrating to children or caregivers or asking them to demonstrate how to use antiasthmatic medications. Multivariate logistic regressions revealed that intention to counsel was a significant predictor of providing counseling for children or caregivers (odds ratio [ OR], 3.95 and 3.09, respectively). Intention to counsel children was significantly associated with subjective norm (OR, 1.88) and perceived ease of counseling (OR, 1.48); intention to counsel caregivers was significantly associated with perceived ease (OR, 1.45). Pharmacists also reported the following barriers that made counseling difficult: lack of time, lack of parent's interest, and lack of placebo devices useful for demonstration of inhalation technique. Conclusion: Despite a positive attitude toward providing asthma counseling, the majority of pharmacists reported not fully engaging in counseling. A number of barriers to counseling were reported that, if targeted, could improve the management of pediatric asthma through pharmacist-initiated counseling.