Clinical Tip: Asthma meds: Getting to the right answer

July 1, 2007

Asking asthma patients about their adherence to a medication regime can elicit answers too vague to be useful. When I talk to an older child (or parents) about the use of controller medication, such as an inhaled corticosteroid, I don't ask whether the child is taking the medication every day. Instead, I ask how many times per week or month he or she takes it. If the patient is using a fluticasone (Flovent) inhaler bid, for example, I ask "of the 14 treatments per week, how many do you actually do, and do you ever miss one?" I preface the question by clarifying that I'm not going to judge the child on the answer-I just need to know so I can tell whether the prescribed dosage is too much or too little or what we could do to make it "14 out of 14."

Asking asthma patients about their adherence to a medication regime can elicit answers too vague to be useful. When I talk to an older child (or parents) about the use of controller medication, such as an inhaled corticosteroid, I don't ask whether the child is taking the medication every day. Instead, I ask how many times per week or month he or she takes it. If the patient is using a fluticasone (Flovent) inhaler bid, for example, I ask "of the 14 treatments per week, how many do you actually do, and do you ever miss one?" I preface the question by clarifying that I'm not going to judge the child on the answer-I just need to know so I can tell whether the prescribed dosage is too much or too little or what we could do to make it "14 out of 14."

Michael Corjulo, APRN, CPNP, AE-C Orange, Conn.