Professional Abstract
Objective
To assess the effectiveness of a prompt list of questions about asthma plus a supporting educational video in increasing youth involvement during medical visits and improving asthma management and quality of life
Study Design
| Design Elements |
Description |
| Design |
Randomized controlled trial |
| Population |
359 youth ages 11–17 with asthma |
Interventions/
Comparators |
- Asthma question prompt list plus a supporting educational video
- No intervention
|
| Outcomes |
Primary: asthma control, asthma management self-efficacy, asthma-related quality of life
Secondary: youth question asking, provider education of youth about asthma, provider inclusion of youth input, youth rating of clinicians as participatory, adolescent satisfaction with medical visit, adherence to asthma medications, youth-reported medication problems, ED visits, unscheduled physician visits, lung function
|
| Timeframe |
1-year follow-up for primary outcomes |
This randomized controlled trial examined the effectiveness of a prompt list plus a supporting educational video in increasing involvement during medical visits and improving health outcomes among youth ages 11–17 with asthma. The prompt list had common questions about asthma medications, triggers, and environmental control, which these patients could ask during their medical visits.
The research team randomly assigned patients to either the prompt list group or the control group. In the prompt list group, patients watched the educational video on a tablet during their pre-visit wait time. The video focused on the importance of youth being involved during visits and using the prompt list. Next, the patients marked questions they wanted to ask on the prompt list. They could give the completed prompt list to their provider at the beginning of the visit or refer to the list to help remember which questions they wanted to ask. In the control group, patients received no intervention before their medical visit.
The study included 359 youths with asthma who received care at four clinics in North Carolina. Among these patients, 37% were African American, 36% were white, 13% were Hispanic, and 11% were Native American. The average age was 13, and 57% were male. Patients had lived with asthma for an average of 10 years.
The research team recorded medical visits at baseline and again 6 and 12 months later. After medical visits, the team interviewed all youth on the study outcomes. Youth who received the prompt list completed it again before their 6- and 12-month follow-up visits. The team repeated the interviews and surveys after those visits.
Youth with asthma, caregivers, and primary care clinicians helped design the study, including the prompt list and educational video.
Results
After one year, asthma control, asthma-related quality of life, and asthma management self-efficacy did not differ between the prompt list and control groups.
Compared with patients in the control group, those in the prompt list group were more likely to ask questions about asthma, receive education on asthma, and rate their clinician as participatory (all p≤0.05). The two groups did not differ in the other secondary outcomes.
Limitations
Patients received care at primary care clinics in North Carolina. The study included youth with and without well-controlled asthma. Results may differ in other settings or specifically among youth whose asthma is poorly controlled.
Conclusions and Relevance
Among youth with asthma, the prompt list plus supporting educational video did not improve asthma management or health outcomes. However, the prompt list improved youth question asking and education given by clinicians during medical visits.
Future Research Needs
Future research could consider testing the effectiveness of prompt lists in different settings or specifically among patients whose asthma is poorly controlled.
