Health care providers often encounter the “doorknob syndrome” during patients' office visits. This occurs just when a patient is about to leave an exam room: She places her hand on a doorknob and mentions that she forgot to ask a question or was unclear about a detail. This could have happened to you. But, there are ways you can communicate more effectively with your provider about your child and her asthma during your visit — instead of just before you leave.

On a Different Wavelength

A survey conducted by the Asthma and Allergy Foundation of America (AAFA) found that asthma patients and mothers of children with asthma and their health care providers may not always “speak” the same language when it comes to discussing asthma control.

This means health care providers were interested in one set of goals, while patients or individuals with children were concerned about another. In the long run, this could lead to what AAFA called less than optimal disease management.

The survey found that health care providers and patients agreed that the most important factors describing asthma control included having few or no asthma symptoms, being able to continue with activities of daily life, not having to use inhalers frequently, and reducing the severity of asthma symptoms. The agreement, though, mostly stopped there.

Health care providers generally asked quantitative questions such as how many triggers a patient had or how often a patient used a fast-acting inhaler or rescue inhaler or experienced asthma symptoms.

Meanwhile, patients and parents were focused on how asthma symptoms could interfere with daily living. For instance, you might be concerned if your children could attend school on certain days or play a sport.

To bridge this gap, AAFA created a “conversational roadmap” that patients or parents of an asthmatic child could fill out when they visited a provider. Helping patients such as children volunteer more information about their asthma could help health care providers determine the best asthma management options for them, according to AAFA.

These questions could be used to expand the dialogue, for instance, by examining how a child's lifestyle has changed since the last visit (for instance, more or less stress, a new school, or a new pet) or if asthma is preventing a child from taking walks or cleaning house. (The questions are available at www.aafa.org.)

Problems with Medications

Another point that may be missing from a dialogue to achieve better asthma control is the use of medications. While health care providers say they are prescribing them, some children may not be using them for a variety of reasons.

For instance, in one study from Johns Hopkins University of children ages five to twelve, a third of caregivers or parents reported not getting an asthma controller medication for their children — even though most of the health care providers said they had been prescribed the medications during patient visits. Almost two-thirds of the children had persistent asthma.

The researchers attributed this underuse of controller medication to poor communication between health care providers and caregivers/parents about the severity of asthma symptoms, the prescribed regimen, or other medications that the patient is using.

In 2006, the Global Asthma Physician and Patient (GAPP) Survey reported results on the first-ever worldwide quantitative survey in regard to asthma attitudes and treatment practices among physicians and patients. The survey found a particular concern about medication side effects and how that could hinder their further use. One-third of those surveyed said they experienced short-term side effects such as hoarseness, fungal infections in their mouths, or sore throat.

About 19 percent of the patients said that they were not aware of the short-term effects, although only 5 percent of the physicians questioned thought that patients were unaware of those effects.

The patients' limited knowledge of side effects may be linked to a communication gap between themselves and physicians, the survey observed: 73 percent of patients who currently are on or have taken asthma medication in the past said they never discussed short-term effects with their physicians. However, 90 percent of physicians said they sometimes or always discussed short-term effects of medications.

If your child is reluctant to use a medication, find out why. If it's causing a side effect — such as a sore throat, a bad taste in his mouth, or an upset stomach — check with your health care provider to see if this is normal or if something else is needed.

Similarly, if the medication doesn't appear to be doing what you think it should for your child, find out why as well. A visit with your health care provider may reveal that the medication is not being used properly by your child or maybe another medication may be needed.

Get a Clear Understanding

While talking to your child's health care provider can be helpful, sometimes it can be intimidating and confusing — especially if the supporting written or verbal information is not clear to you or is written in a language with which you are not totally familiar.

Actually, this is a very common problem. According to the Partnership for Clear Health Communication, a coalition of patient, business, and medical groups, low health literacy — the ability to read, understand, and act on health care information — affects 90 million people in the United States.

This means that you might not be alone in trying to decipher what treatment and management techniques you will need to adopt to care for your child. Fortunately, a move is on in the medical community to improve these literacy levels, and make sure that all individuals understand what the medication is for and how it should be used.

To improve understanding, the partnership recommended three questions (adapted here for parents with children) that individuals can ask at each medical appointment:

• What is my child's main problem?

• What do I need to do?

• Why is it important for me (and my child) to do this?

Keeping those three key points in mind may be able to promote better health care outcomes.