Clinical Tip: Asthma meds: Getting to the right answer

Asking asthma patients about their adherence to a medication regime can elicit answers too vague to be useful. When I talk to an older child (or parents) about the use of controller medication, such as an inhaled corticosteroid, I don't ask whether the child is taking the medication every day. Instead, I ask how many times per week or month he or she takes it. If the patient is using a fluticasone (Flovent) inhaler bid, for example, I ask "of the 14 treatments per week, how many do you actually do, and do you ever miss one?" I preface the question by clarifying that I'm not going to judge the child on the answer-I just need to know so I can tell whether the prescribed dosage is too much or too little or what we could do to make it "14 out of 14."

Michael Corjulo, APRN, CPNP, AE-C Orange, Conn.