Advancing analytic methods to understand asthma control and disease morbidity

摘要

Best practices for asthma treatment are well established, and most individuals' asthma can be controlled with optimal therapy. Adherence to treatment plans has been more difficult to ensure, and a substantial literature has focused on interventions to increase adherence to prescribed treatments, particularly the controller medications. More recently, attempts to understand the determinants of nonadherence have broadened to include the patient perspective, including their understanding of asthma as a chronic illness, concern about long-term consequences of medication use, cultural influences, behavioral impediments, and neighborhood influences.Pediatric asthma has an additional complexity because the parent is an interface between the child and the medical care system and instrumental in assuring adherence. Conceptually, this model is multilevel, multidimensional, and interactive, as shown in Fig 1, where the adhesive strip represents the health outcome-that is, asthma control-and the eye represents theparent perspective in reporting on the child.