Increasing Medication Compliance in Pediatric Asthma Patients by Implementing a Home Medication Dosing Chart

Background: There are 6.2 million children under the age of 18 years who have an asthma diagnosis (Center for Disease Control and Prevention, 2017). Only 60% of children ages 7-17 years with persistent asthma maintain their prescribed inhaled corticosteroid (ICS) controller medication regimen (Arnold, Bixenstine, Cheng, & Tschudy, 2018). The purpose of this paper is to discuss a practice inquiry project that incorporated the implementation of an asthma medication dosing chart to increase compliance in pediatric asthma patients. Method: The quasi-experimental pretest-posttest design evaluated the daily use of a medication dosing chart, which was to serve as a physical reminder for children and their families to take their daily inhaled corticosteroid as prescribed. Emergency room visits, hospital admissions, missed ICS doses, rescue inhaler and oral steroid use were measured to determine if increased dosing compliance influenced how well the pediatric patient’s asthma is controlled. Results: Of the pre-intervention group (n=27), only 13 attended the follow-up visit and completed the post-intervention survey. There was statistical significance (p=.002) with missed ICS doses, it decreased from an average of 1.7 missed doses per week to an average of .31 doses. A decrease in ED visits (p=.226), decrease in hospitalizations (p=.393), and oral steroid courses from (p=.730) were noted but not deemed statistically significant. Rescue inhaler use decreased from an average of 1.89 times per week to 1.08 times (p=.254). Conclusion: Having a decrease in the number of missed ICS doses per week is the most significant measure that demonstrated improved compliance. While all other measures had notable decreases, based on the small post-intervention sample size (n=13) there was not statistical significance seen with improved compliance based on the use of the medication dosing chart. Further studies on a larger scale over a longer period are recommended

Batterer intervention program facilitators\u27 perceptions of the efficacy of current behavior intervention models

This qualitative study explored the question: Is the extensive use of the Duluth Model in the treatment of perpetrators of domestic violence and its derivatives based on perceived efficacy among the facilitators of these programs, or is there a more effective model that is suggested based upon their experiences? A flexible research design was utilized in order to explore the experience of 12 Batterer Intervention Program (BIP) facilitators through the process of in depth, individual interviews. The major themes identified were the facilitators\u27 need for change in the interventions utilized, their experience of powerlessness within their field, and their desire for greater community support to hold perpetrators accountable and affect change in their behavior. Among the facilitators interviewed, there was a predominant opinion that an intervention which expands upon existing Duluth based BIP methodology would be more successful in changing batterer behaviors