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 1 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 1 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.