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. 2018 Jun;55(6):675-683.
doi: 10.1080/02770903.2017.1362423. Epub 2017 Oct 11.

Impact of shared decision making on asthma quality of life and asthma control among children

Yhenneko J Taylor  1 , Hazel Tapp  1 , Lindsay E Shade  1 , Tsai-Ling Liu  1 , Jessica Lauren Mowrer  1 , Michael F Dulin  1   2
Affiliations

Impact of shared decision making on asthma quality of life and asthma control among children

Yhenneko J Taylor et al. J Asthma. 2018 Jun.

Abstract

Objective: Few studies have examined the effectiveness of shared decision making (SDM) in clinical practice. This study evaluated the impact of SDM on quality of life and symptom control in children with asthma.

Methods: We conducted a prospective 3-year study in six community-based practices serving a low-income patient population. Practices received training on SDM using an evidence-based toolkit. Patients aged 2-17 with a diagnosis of asthma were identified from scheduling and billing data. At approximate 6-month intervals, patients completed a survey consisting of the Mini Pediatric Asthma Quality of Life Questionnaire (range 1-7) and the control domain of the Pediatric Asthma Therapy Assessment Questionnaire (range 0-7). We used propensity scores to match 46 children receiving SDM to 46 children receiving usual care with decision support. Included children had completed a baseline survey and at least one follow-up survey. Random coefficient models incorporated repeated measures to assess the effect of SDM on asthma quality of life and asthma control.

Results: The sample was primarily of non-White patients (94.6%) with Medicaid insurance (92.4%). Receipt of SDM using an evidence-based toolkit was associated with higher asthma quality of life [mean difference 0.9; 95% confidence interval (CI) 0.4-1.4] and fewer asthma control problems (mean difference -0.9; 95% CI -1.6--0.2) compared to usual care with decision support.

Conclusions: Implementation of SDM within clinical practices using a standardized toolkit is associated with improved asthma quality of life and asthma control for low-income children with asthma when compared to usual care with decision support.

Keywords: Asthma therapy assessment questionnaire (ATAQ); Medicaid; mini asthma quality of life questionnaire (AQLQ); practice-based research; propensity score.

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Conflict of interest statement

Declaration of Interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

Figures

Figure 1.
Figure 1.
Diagram of study sample selection *SDM=shared decision making
See this image and copyright information in PMC

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