With Arlene Butz, Sc.D, RN, MSN, CPNP - Part 1 of 4

Recorded at the "Clearing the Air" conference addressing asthma disparities in Maryland on June 28th, 2011. Held at the Maritime Institute Conference Center in Linthicum, MD.

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B-4. The Human Side of Asthma: Educating Patients to Make Healthy Decisions - Overcoming Barriers to Medication Adherence
Panelists: Arlene Butz, Sc.D, RN, MSN, CPNP, Johns Hopkins Bayview Medical Center Greg Diette, M.D., MHS, Johns Hopkins School of Medicine, Associate Professor & Director Clinical Research, Division of Pulmonary & Critical Care Medicine
Bernard Abbott, M.D., South Baltimore Family Health Center, Medical Director, Pediatrician

Health disparities and adherence are uniquely interrelated. Multiple factors coalesce unfavorably by race. These include poverty, education, occupation, health care access, ambient air pollution, adherence, allergens and indoor pollution. How is communication central to health disparities? Are there race di￿erences associated with adherence? Is asthma care worse in a particular racial community? Learn the answers to these questions and about multi faceted interventions from both
a macro (systems) and micro (clinic) level -- both of which are needed to impact this chronic disease.
Although anti-in￿ammatory medication remains the cornerstone of treatment for persistent asthma, only about 50% of inhaled medications are taken as prescribed and adherence does not improve with increased severity. To understand adherence one must understand the culture and social context of the patient and how they integrate the asthma treatment into his/her everyday life. There are several types of non-adherence including intentional, erratic and unwitting. Several barriers to appropriate medication adherence include parental worry and concern regarding medication side e￿ects, confusion with aerobic steroids; complex dosing regimens, cost of medications and poor health care provider-parent communication. Providing parents with pharmacy re￿ll records and conveying the number of ￿lls of anti-in￿ammatory and rescue medications ￿lled over the past 12 months has motivated some parents to increase adherence to anti-in￿ammatory medications. This presentation will de￿ne adherence, discuss the types of adherence and present evidence-based interventions that promote medication adherence and provide practical tips to improve patient adherence from multiple perspectives.

Arlene Butz, Ph.D., RN is a Pediatric Nurse Practitioner at Johns Hopkins Bayview Medical Center, Professor of Pediatrics at the Johns Hopkins School of Medicine and School of Nursing, has been working with children with asthma over the past 20 years and has been conducting studies of behavioral interventions for children with asthma for over 10 years. She tests interventions aimed at enhancing parent and provider education. Her most recent research includes studies of use of home air ￿lters to reduce particulate levels in households with smokers, use of health, pharmacy and cotinine-level feedback to parents and health care providers to increase appropriate use of controller medications and reduce symptomatic
days and nights.

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