Successful asthma management in children requires an appropriate division of responsibility for management tasks between patient and their family. Non-adherence may result without appropriate assignment or acceptance of responsibility for these tasks. A study by Munzenberger and colleagues explored the relationship between selected child, caregiver, family, asthma characteristics, and responsibility for self-management activities. Child and caregiver perceived responsibility for selected tasks were determined and described via means and mean summary scores. Child, caregiver, family, and asthma characteristics were determined via interview and chart review; they were described by means or proportions. Pearson's correlation coefficient (r) examined any relationship between these characteristics and perceived levels of responsibility. Multiple regression techniques examined whether the affect of child, caregiver, family, and asthma characteristics influenced perceived levels of responsibility for asthma management. One hundred and four child and caregiver pairs were enrolled. Mean caregiver scores for all tasks suggest responsibility for each most of the time. The mean child scores for all tasks suggest an unwillingness to assume responsibility most or all of the time. Regression analysis indicated that patient age (r(2) = 0.344), number of hospital admissions (r(2) = 0.052), and PEF (r(2) = 0.106) had the best predictive strength for the patient summary score. Only patient age (r = 0.486) was a significant predictor for the caregiver summary score.

WHAT THIS MAY MEAN TO YOU AS A HEALTH CARE PROVIDER: The authors conclude that children and caregivers perceive differently responsibility for asthma management tasks. Patient age had the best predictive strength for both patient and caregiver responsibility.

WHAT THIS MAY MEAN TO YOU AS A PATIENT OR PARENT: There is solid data that shows that children as young as 5 years of age can be taught asthma self-management skills. They will perform the skills if taught in a self-management program that assesses both learning and performance. Parents should be involved, but basically as coaches and to provide reinforcement for their children’s’ successful performance. The current study certainly found such a need in participants.

P Munzenberger et al. Relationship between Patient, Caregiver, and Asthma Characteristics, Responsibility for Management, and Indicators of Asthma Control within an Urban Clinic. Journal of Asthma, 2010;47:41-45.