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 About a third of teens with asthma do ask questions of doctors, but
parents typically do most of the talking, the study authors found.
"As teens grow up and become more independent, it becomes more and
more important that they can manage their asthma on their own,
without relying on their parents," coauthor Scott Davis of the
University of North Carolina at Chapel Hill told Reuters Health by
email. "If we can make teens more confident in asking their doctors
the questions they have, they may be more likely to learn the skills
they need to control their asthma."
Writing in the Journal of Allergy and Clinical Immunology: In
Practice, Davis and colleagues describe what happened when they gave
185 asthmatic adolescents a one-page list of 22 questions about
asthma medications and asthma triggers, before the youngsters
doctors' appointments.
Previous studies have shown that physician-patient interactions are
improved when patients have access to a "question prompt list,"
which allows them to check the questions they want to ask during a
visit and write in their own questions.
On average, teens in the current study checked about four questions.
About 11 percent wrote in one or two questions.
The most frequently checked question was "How severe is my asthma?"
which was checked by about half of the teens. About a third of teens
who checked questions asked, "What causes my asthma?" and "How can I
make my asthma better?" The most frequently checked medication
questions were, "How long do I hold my breath after I inhale my
medicine?" and, "Should I use my asthma medicine before I play or
exercise?"
Only about a third of kids who checked at least one question
actually asked at least one question during their appointment.
The question most often asked after being checked on the list was,
"What causes my asthma?" However, only 10 percent of teens who
checked "How do I prevent breathing problems?" actually asked the
question.
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Of the asthma medication questions, 40 percent of teens who checked
"Should I always carry my asthma medicine with me?" and "Is it okay
to take my asthma medicine with my other medicines?" raised those
questions with their doctor. At the same time, nobody who checked
important questions such as "Can you show me how to use my
medicine?" and "Can I show or tell you how I use my medicine, so you
can tell me if I am doing it right?" actually asked their doctor.
"Parents have a role to play in empowering their teens to speak up
during medical visits and ask questions," Davis said. "Teens with
asthma especially need to know how to use their inhaler correctly
but are often reluctant to ask their doctor to show them."
"As a clinician, it becomes second nature to direct conversation to
the adult caregiver, especially if there is a longstanding
relationship between provider and caregiver," said Dr. Tamara Perry
of the University of Arkansas for Medical Sciences in Little Rock.
Perry, who wasn't involved with this study, has researched how teens
may use smartphone apps for self-management of their asthma.
"As children grow up, clinicians and caregivers have to be
intentional and remain mindful that adolescents don't always feel
empowered to ask questions," she told Reuters Health by email. "It's
up to us to help them engage in their care by bringing them into the
conversation."
SOURCE: http://bit.ly/2Xrg2pr Journal of Allergy and Clinical
Immunology: In Practice, online February 15, 2019.
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