ATS 2021 will feature presentations of original research from accepted abstracts. Mini Symposia and Thematic Poster Sessions are abstract based sessions.
Please use the form below to browse scientific abstracts and case reports accepted for ATS 2021. Abstracts presented at the ATS 2021 will be published in the Online Abstract Issue of the American Journal of Respiratory and Critical Care Medicine, Volume 203, May 3, 2021.
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Alignment and Discordances in Shared Decision-Making Perceptions Among Asthma Patients and Their Care Teams
Session Title
TP15 - TP015 UPDATES IN ADHERENCE AND TREATMENT OF LUNG DISEASE
Abstract
A1643 - Alignment and Discordances in Shared Decision-Making Perceptions Among Asthma Patients and Their Care Teams
Author Block: A. H. Liu1, M. Kraft2, J. D. Field3, Y. K. Persaud4, M. Nelson5, J. Carter5, L. Simone5; 1Pediatrics, Children's Hospital Colorado, Aurora, CO, United States, 2Dept of Medicine, Univ of Arizona Health Sciences Ctr, Tucson, AZ, United States, 3Allergy and Asthma Care of New York, New York, NY, United States, 4Icahn School of Medicine at Mount Sinai, New York, NY, United States, 5PRIME Education, Fort Lauderdale, FL, United States.
Rationale: Shared decision-making (SDM) between asthma patients and providers has been shown to improve outcomes and is recommended by clinical guidelines. We assessed alignment and discordance in SDM perceptions among asthma patients and their care teams.
Methods: Between 12/2019 and 03/2020, surveys were administered to 25 healthcare professionals (HCPs; 4% pulmonologists, 44% allergists/immunologists, 12% physician assistants, 32% nurses, 8% other) and 137 of their asthma patients (71% female, average age 41 years). Surveys were administered before and after 1.25-hour educational sessions for patients, which were led by providers in each of the 10 participating community-based clinics, the majority of which were allergy and asthma practices. The clinicians had an average of 12 years of experience caring for patients with asthma.
Results: Alignment was found in patients’ and HCPs’ perceptions of communication: 69% of patients reported high confidence in sharing about asthma symptoms and their impact with their provider; 67% of HCPs indicated that they were fully aware of how asthma affects their patients’ quality of life and activities of daily living. Alignment was also observed regarding involvement in decisions about asthma treatment: 66% of patients reported they were very or extremely involved vs. 72% of HCPs who believed their patients had this level of involvement. Discordance was observed in the top three goals for asthma treatment. HCPs believed their patients’ top goals to be controlling symptoms (63%), not needing to go to the emergency room/urgent care (42%), and preventing asthma attacks (42%). While patients did list controlling symptoms (70%) and preventing asthma attacks (36%), the second most commonly reported goal was being able to do the things they want to do (46%). Discordance was also observed in perceptions of asthma control. Seventy-one percent of patients believed their asthma was well-controlled, whereas HCPs estimated that 52% of the patients had well-controlled asthma. Fifty-seven percent of patients vs. 26% of HCPs reported that they/their patients were not at all limited in going to public places. Similar results were observed for household chores, interacting with others, and exercising.
Conclusions: While patients and HCPs were aligned around the issue of involvement in decisions about asthma treatment, there was less agreement around goals for asthma treatment and asthma control. The observed alignments and discordances in patient and provider perceptions may inform strategies to support effective communication and shared decision-making in asthma care.
Author Block: A. H. Liu1, M. Kraft2, J. D. Field3, Y. K. Persaud4, M. Nelson5, J. Carter5, L. Simone5; 1Pediatrics, Children's Hospital Colorado, Aurora, CO, United States, 2Dept of Medicine, Univ of Arizona Health Sciences Ctr, Tucson, AZ, United States, 3Allergy and Asthma Care of New York, New York, NY, United States, 4Icahn School of Medicine at Mount Sinai, New York, NY, United States, 5PRIME Education, Fort Lauderdale, FL, United States.
Rationale: Shared decision-making (SDM) between asthma patients and providers has been shown to improve outcomes and is recommended by clinical guidelines. We assessed alignment and discordance in SDM perceptions among asthma patients and their care teams.
Methods: Between 12/2019 and 03/2020, surveys were administered to 25 healthcare professionals (HCPs; 4% pulmonologists, 44% allergists/immunologists, 12% physician assistants, 32% nurses, 8% other) and 137 of their asthma patients (71% female, average age 41 years). Surveys were administered before and after 1.25-hour educational sessions for patients, which were led by providers in each of the 10 participating community-based clinics, the majority of which were allergy and asthma practices. The clinicians had an average of 12 years of experience caring for patients with asthma.
Results: Alignment was found in patients’ and HCPs’ perceptions of communication: 69% of patients reported high confidence in sharing about asthma symptoms and their impact with their provider; 67% of HCPs indicated that they were fully aware of how asthma affects their patients’ quality of life and activities of daily living. Alignment was also observed regarding involvement in decisions about asthma treatment: 66% of patients reported they were very or extremely involved vs. 72% of HCPs who believed their patients had this level of involvement. Discordance was observed in the top three goals for asthma treatment. HCPs believed their patients’ top goals to be controlling symptoms (63%), not needing to go to the emergency room/urgent care (42%), and preventing asthma attacks (42%). While patients did list controlling symptoms (70%) and preventing asthma attacks (36%), the second most commonly reported goal was being able to do the things they want to do (46%). Discordance was also observed in perceptions of asthma control. Seventy-one percent of patients believed their asthma was well-controlled, whereas HCPs estimated that 52% of the patients had well-controlled asthma. Fifty-seven percent of patients vs. 26% of HCPs reported that they/their patients were not at all limited in going to public places. Similar results were observed for household chores, interacting with others, and exercising.
Conclusions: While patients and HCPs were aligned around the issue of involvement in decisions about asthma treatment, there was less agreement around goals for asthma treatment and asthma control. The observed alignments and discordances in patient and provider perceptions may inform strategies to support effective communication and shared decision-making in asthma care.
