By Carolyn Crist

(Reuters Health) – Adolescents with asthma don’t always speak up during doctor visits and often leave with questions, a study suggests.

About a third of teens with asthma do ask questions of doctors, but parents typically do most of the talking, the study authors found.

“As teens grow up and become more independent, it becomes more and more important that they can manage their asthma on their own, without relying on their parents,” coauthor Scott Davis of the University of North Carolina at Chapel Hill told Reuters Health by email. “If we can make teens more confident in asking their doctors the questions they have, they may be more likely to learn the skills they need to control their asthma.”

Writing in the Journal of Allergy and Clinical Immunology: In Practice, Davis and colleagues describe what happened when they gave 185 asthmatic adolescents a one-page list of 22 questions about asthma medications and asthma triggers, before the youngsters doctors’ appointments.

Previous studies have shown that physician-patient interactions are improved when patients have access to a “question prompt list,” which allows them to check the questions they want to ask during a visit and write in their own questions.

On average, teens in the current study checked about four questions. About 11 percent wrote in one or two questions.

The most frequently checked question was “How severe is my asthma?” which was checked by about half of the teens. About a third of teens who checked questions asked, “What causes my asthma?” and “How can I make my asthma better?” The most frequently checked medication questions were, “How long do I hold my breath after I inhale my medicine?” and, “Should I use my asthma medicine before I play or exercise?”

Only about a third of kids who checked at least one question actually asked at least one question during their appointment.

The question most often asked after being checked on the list was, “What causes my asthma?” However, only 10 percent of teens who checked “How do I prevent breathing problems?” actually asked the question.

Of the asthma medication questions, 40 percent of teens who checked “Should I always carry my asthma medicine with me?” and “Is it okay to take my asthma medicine with my other medicines?” raised those questions with their doctor. At the same time, nobody who checked important questions such as “Can you show me how to use my medicine?” and “Can I show or tell you how I use my medicine, so you can tell me if I am doing it right?” actually asked their doctor.

“Parents have a role to play in empowering their teens to speak up during medical visits and ask questions,” Davis said. “Teens with asthma especially need to know how to use their inhaler correctly but are often reluctant to ask their doctor to show them.”

“As a clinician, it becomes second nature to direct conversation to the adult caregiver, especially if there is a longstanding relationship between provider and caregiver,” said Dr. Tamara Perry of the University of Arkansas for Medical Sciences in Little Rock. Perry, who wasn’t involved with this study, has researched how teens may use smartphone apps for self-management of their asthma.

“As children grow up, clinicians and caregivers have to be intentional and remain mindful that adolescents don’t always feel empowered to ask questions,” she told Reuters Health by email. “It’s up to us to help them engage in their care by bringing them into the conversation.”

SOURCE: Journal of Allergy and Clinical Immunology: In Practice, online February 15, 2019.