Tales of pediatric asthma management: Family-based strategies related to medical adherence and health care utilization

Objectives To examine how family management styles, garnered from parent interviews about the effect of asthma on family life, are related to medical adherence and health care utilization. Study design Eighty parents with a child with asthma were interviewed. Computerized monitoring of medication use was collected every 2 months for I year. Parents and children completed measures of medical adherence and health care utilization at the time of the interview and at 1-year follow-up. Three categories of disease management were identified: reactive, coordinated care, and family partnerships. Group comparisons were made by using analysis of variance with medical adherence and health care utilization as dependent variables. Results Management strategies revealed in the interview were distinguishable by adherence rates at the time of interview and 1 year after. Interview categories were also predictive of emergency department use at 1-year follow-up. The reactive group received a diagnosis of asthma I year after noting symptoms, in contrast with the other groups, who received a diagnosis within 6 months. Conclusions The use of semistructured interviews may reveal important information about how families manage asthma. Further work may help identify areas amenable to intervention and provide a better understanding of why some families delay treatment.