Consensus communication strategies to improve doctor-patient relationship in paediatric severe asthma

Antonietta Cappuccio,Filomena Bugliaro,Alessandro Policreti,Lucia Caminiti,Anna Lucania,Enrico Lombardi,Margherita Marchiani,Elio Novembre ,Valeria Caldarelli,G Pellegrini ,Maria Giulia Marini,Alessandro Fiocchi ,Silvia Caimmi ,Maria Carmela Montera,Ahmad Kantar,Marzia Duse,Francesco Gesualdo,Gian Luigi Marseglia ,Emanuela Di Palmo,Giorgio Piacentini,Enza D’Auria,Francesca Santamaria

doi:10.1186/s13052-019-0623-0

Abstract

BackgroundAsthma is a chronic inflammatory disease that is very common among youth worldwide. The burden of this illness is very high not only considering financial costs but also on emotional and social functioning. Guidelines and many researches recommend to develop a good communication between physicians and children/caregiver and their parents. Nevertheless, a previous Italian project showed some criticalities in paediatric severe asthma management. The consensus gathered together experts in paediatric asthma management, experts in narrative medicine and patient associations with the aim of identify simple recommendation to improve communication strategies.MethodsParticipants to the consensus received the results of the project and a selection of narratives two weeks before the meeting. The meeting was structured in plenary session and in three working groups discussing respectively about communication strategies with children, adolescents and parents. The task of each working group was to identify the most effective (DO) and least effective practices (DON’ T) for 5 phases of the visit: welcome, comprehension of the context, emotions management, duration and end of the visit and endurance of the relationship.ResultsParticipants agreed that good relationships translate into positive outcomes and reached consensus on communication strategies to implement in the different phase of relationships.ConclusionsThe future challenges identified by the participants are the dissemination of this Consensus document and the implementation of effective communication strategies to improve the management of pediatric asthma.

Highlights

Asthma is a chronic inflammatory disease that is very common among youth worldwide
Cappuccio et al Italian Journal of Pediatrics (2019) 45:31 of asthma undermine patients’ and caregivers’ emotional, psychological and social functioning by limiting their ability to engage in normal day activities [10, 11]
[12] Many studies demonstrated the efficacy of health communication intervention to improve the doctor-patient/parent relationship and diminish non-adherence and access to Emergency December (ED). [13,14,15,16] The benefit of doctor-patient communication may extend beyond these short-term outcomes, as demonstrated on other adult chronic diseases [17,18,19]

Summary

Introduction

Asthma is a chronic inflammatory disease that is very common among youth worldwide The burden of this illness is very high considering financial costs and on emotional and social functioning. Asthma is very common among youth worldwide, with approximately 7% of adolescents and 5% of children reporting symptoms of severe asthma [3] The burden of this disease is very high and it causes numerous school absence and visits to the emergency. [13,14,15,16] The benefit of doctor-patient communication may extend beyond these short-term outcomes, as demonstrated on other adult chronic diseases [17,18,19] Despite this evidence, children and adolescents are rarely engaged in discussion during medical visits, accounting for only 3–15% of the total medical visit interactions [20]. Carpenter and colleagues demonstrated that providers engage their patients less frequently than these children and adolescents preferred [13]

Methods

Results

Conclusion