Sabrina Wang

9/29/2015
Period 6
Annotated Source List
Aucoin, Robert G. "Pediatric Pharmacotherapeutic Education: Current Status
and Recommendations to Fill the Growing Need." Journal of Human Pharmacology and
Drug Therapy 25.9: n. pag. Print.
The purpose of this article was discuss the Accreditation Council for Pharmacy Education
and the Canadian Council for Accreditation of Pharmacy Programs and the fact that each of their
programs should provide a curriculum suitable to give in order to produce general practitioners
of pharmacy. According to this article, the requirements to fulfill the stated mandate, include
adequate content dedicated to pharmaceutical care of the pediatric patient; however, current
pediatric curriculum is inadequate and must be improved to reach the state mandate. Pediatric
topics should be introduced early to increase the students' awareness of the special needs of this
extremely susceptible population. Other recommendations from the curriculum include the
provision of at least 25 hours of instruction in core pediatric areas and at least one pediatric
clinical rotation for all students. This article also suggested that pharmaceutical care of pediatric
patients can also be improved by offering pediatric rotations to all pharmacy practice residents
and encouraging their participation.
This article educated me in the growing need for general practitioners in the pharmacy
industry. Furthermore, I learned about the lack of adequate information in current pediatric
curriculum for students, which I had never known about before. Since I want to go into
pharmacy, I should take into consideration how many hours of instruction I will need to take and
the requirements I will need to fulfill in order to become a full fledged practitioner.

Butz, Arlene M. "Shared decision making in school age children with asthma." US National
Library of Medicine National Institutes of Health (2007): 111-17. Print.

This article discusses the topic of how decision making in health care typically takes
place between the health care provider and the patient. However, with pediatric patients, children
have little involvement during their medical care visits or in decisions regarding their health care.
The study believes that allowing children with asthma to take part in the decision making could
enhance their self-confidence and improve their self-management skills. Specific communication
techniques talked about in this article include visual aids, turn-taking, clarifying communication,
and role modeling. Providers can also offer strategies to parents on how to provide general
information about asthma and treatments based on the child's questions and interest.
I can use this article to help brainstorm different techniques to better educate asthmatic
pediatric patients and strategies I can give to the parents in order for them to assist their child
with the management of their asthma. This article assures me that there will be a benefit from my
pamphlets/videos for both the patients and the parents. Allowing the child to participate during
the visit requires assessing the child's competence at different ages and abilities. This article
brought to my attention that fact that permitting children to have a voice in their visits to the
hospital or decisions relating to their asthma can not only improve their confidence, but help
them gradually learn to manage their asthma on their own.

Cleveland, Kelli K. "Evidence-based asthma education for parents." Journal for Specialists in
Pediatric Nursing 18.1 (2013): 25-32. Print.
The article Evidence based asthma education for parents from the Journal for Specialists
in Pediatric Nursing was an investigation that's purpose was to develop and implement an
asthma brochure for parents of pediatric asthma patients. The asthma patients were ages 4-12,
and the number of office sick visits, emergency department visits, and hospitalizations having to
do with asthma were measured pre and post evaluation. Through the experiment, although no
significant trends were noticed, there were positive changes in asthma education within the
pediatric clinic and future suggestions were made because of it.
This article can help me for my future plans this year because it gives specific
information on what was shown in the brochures that were given to the parents. The study also
gives detailed information on how the results were collected and analyzed which will help me
gather my results and take information from them. The idea of taking numbers of ED visits and
hospitalizations is a possible suggestion for my project this year, and the experiment also takes
into account several different demographic variables which I did not think to include, such as
race and use of daily control medications.

"Factors associated with emergency department visits by children with asthma: implications for
health education." American Journal of Public Health: n. pag. Print.
This article from the American Journal of Public Health discussed a study that
investigated the relationship between psychosocial and behavioral factors and the frequency of
emergency department visits for childhood asthma. Parents of 445 children who were being
treated for asthma in the emergency room of a large urban hospital were surveyed. Results of the
study found that factors associated with high numbers of emergency department visits included
the younger age of a child, a greater number of days with symptoms of asthma, a higher number
of asthma medicines prescribed, a prior hospitalization for asthma, a lower level of parental
confidence in the efficacy of medicines, and a failure to correctly decide when it was appropriate
to visit the emergency department.
I gained information from this article as well because the study demonstrated that
younger children with asthma who were also previously hospitalized for asthma are at a higher
risk for needing to visit the emergency department. The study also told me that families who use
the emergency department frequently need to be further educated in the inflammatory nature of
asthma, in the outcomes of proper use of medication, in the need for ongoing care, and in criteria
for how to differentiate between those symptoms that can be handled at home and those that
require emergency care. These may all be areas that I can include or elaborate on in my
brochures for the providers of pediatric patients, as they may be too complex for children of
younger ages.
Flapper. "Happiness to be gained in paediatric asthma care." Official Scientific Journal of the
ERS: n. pag. Print.
The aim of the study in this article was to establish the efficiency with regards to healthrelated quality of life (HRQoL) of a group asthma education program to children with low
quality-of-life scores. There was a total of 53 unhappy children out of 204 participants., The
average age was 10 years, with an age range of 8-12 yrs. Measurements were taken at the start
and after 3, 6, and 9 months. From the start to 6 months, changes in HRQoL were significantly
greater in the intervention group than in the control group, both for generic HRQoL and
for asthma-specific HRQoL. Measurements taken at nine months were consistent with the results
found at 6 months. The changes in sick days and doctor visits over a 6-month period were greater
in the intervention group than in the control group, showing that an asthma education program
does help.
Again, this study proves to me the importance of quality of life for a children and the
direct impact it has on a child's disease, specifically for asthma. Through this article, I was able
to learn that for unhappy children, their quality of life can improve with a even a low
intensity asthma education program, not taking into account any gains in their lung function.
This can be a topic that I can address slightly within my educational pamphlets for adults, so that
they are aware of the importance of living a healthy and balanced life. Furthermore, I took note
of the time intervals at which measurements were taken, and the age range of the participants.

Gent, Janneane F. "Association of pediatric asthma severity with exposure to common household
dust allergens." Environmental Research: n. pag. Print.
This article from the Environmental Research journal investigated the health impact of
five different allergens and the dose response relationships on asthma severity, measured through
symptom frequency and medication use. Children diagnosed with asthma from the ages of 4-12
were followed for one year. Allergen samples were taken from two indoor environments and
daily symptoms and medication use was taken through month survey calls. Increased allergen
concentration and higher pet allergen levels were related to more severe asthma. The
experimenters concluded with the fact that higher levels of pet allergens and dust allergens were
associated with more severe asthma.
I can gain helpful knowledge from this article because it specifies the age group that was
tested and talks about the impact that the household in which the child lives in may have on the
child's disease. Because my project for this year will also consist of parents and how they may
influence their children's disease whether it be for medication or just severity in general, this
relates to how the dirtier the parent's keep the house, the worse the child's asthma will be. It gives
me an idea of how interviews and results can be collected without meeting in person, even
though I will be able to talk to my participants in person.
Goralski, Jennifer L. "Breathing easier: Addressing the challenges of aerosolizing medications to
infants and preschoolers." Respiratory Medicine 108.8: n. pag. Print.

This article from the Journal of Respiratory Medicine talks about aerosol therapy, which
is only useful if it is consistently delivered in the desired dose to the lower respiratory tract.
Many factors affect this in young children, including anatomical and physiologic differences
between adult and children patients, the challenge of administering medication to uncooperative
children, and behavioral adherence. This article also discusses how the techniques used to
evaluate aerosol delivery to pediatric patients need to be carefully evaluated as new therapies and
drug-device combinations are tested. This review addresses a few of the challenges of delivering
aerosolized medications to pediatric patients.
From this article, I was able to gain valuable information on a different type of therapy
for managing asthma that is applicable to both adults and children. It also brought to my
attention that there is a steady stream of creations of new drugs and therapies that I could look
into and research about the pros and cons of. With this research, I will be more knowledgeable
when the time comes for me to answer questions that the patients of their parents have, even
though my mentor will be there to help.

Hersh, Adam L. "Decreasing Frequency of Asthma Education in Primary Care." Journal of

Asthma 47.1 (2010): 21-25. Print.
This article from the Journal of Asthma investigated the national trends in the provision
of asthma education by primary care physicians in office settings. They used the National
Ambulatory Medical Care Survey, a nationally representative dataset of patient visits to officebased physicians, and then identified which of the visits were asthma related. Afterwards, they
estimated the percentage of the visits that provided asthma education. Data were available for
asthma-related visits from the years 20012006 and 20052006 only for asthma-unrelated visits.
Time trends were also examined in asthma education and multivariable logistic regression was
used to identify independent patient and system-related factors that were predictors of asthma
education. The percentage of asthma-related visits where asthma education was found to have
declined during the study period, from 50% in 20012002 to 38% in 20052006. It was
concluded that asthma education is lacking in primary care physician offices, and interventions
designed to promote awareness and greater use of asthma education are needed.
I can learn valuable knowledge from this source because it emphasizes the need for
patient education in pediatric asthma patients through visuals and statistics that demonstrate the
significant decrease in patient asthma education. They investigates different factors that may
have prevented patients from receiving education. Because one of my end goals for this year is to
have an decrease in asthma management issues and visits to the University of Maryland Medical
Center PICU, it is reassuring to know that a similar study found that locations that provided
education had a decline in asthma related visits.
Higgins, James C. "Influence of an interventional program on resource use and cost in pediatric
asthma." AJMC Managed Markets Network: n. pag. Print.
This study was performed in order to determine whether patient education to a primary
care provider improve outcomes and cost in the management of asthma of pediatric patients. In
this study, 61 patients were fully reviewed, and data were obtained from health and pharmacy
records. These pediatric asthma patients were noted to be frequent users of emergency
department services and had no primary care provider and were given asthma education along
with being assigned a provider trained in the national asthma guidelines. Hospital admissions,
Emergency Department and clinic visits among multiple other factors were recorded for an
average of 58.1 months before and 11.2 months after the intervention. All measured parameters
showed favorable changes after intervention. Monthly admissions, emergency department visits,
and clinic visits also decreased after the intervention when evaluated after 22.8 months.
This article and study is helpful to me in that is directly proportional to my project for
this year. The results found by the study are given in very specific detail and gives me an idea of
the time period in which the investigation took place. Although I do not have as much time to
collect data, I can also record hospital admissions and well as number of emergency department
visits to UMMC for my participants and use those numbers to help me conclude whether or not
my pamphlets and/or videos are making a positive change in the lives of my patients or whether I
should alter them in certain ways, so that they can better manage their asthma.

Horner, Sharon D. "Effect of Education on School-Age Children's and Parents' Asthma

Management." Journal for Specialists in Pediatric Nursing (2004): n. pag. Print.
This experiment recognizes the fact that asthma is the most common chronic illness
among children, with it disproportionately affecting those who are poorer and who are of an
ethnic minority. The duration of this experiment lasted for a year, and tested the effectiveness of
intervention that included school based small education for children and home based education
for parents. Changes in understanding were tested based on pretest and posttest measures. Forty
four families completed the experiment, with 46% of those families being low income or
working class. Asthma management improved significantly after 6 months and eventually
stabilized by the end of the study. This improvement was seen the most among poorer children.
As a conclusion, the results pointed to continuous patient education in order to maintain proper
asthma management for both children and adults.
I can gain information from this article because this study focused on patient education
and its direct effect on asthma management which is what I wish to pursue as my intern mentor
project for this year. It also provides interesting statistics on how many of the families that
participated were ethnic minorities and what their wealth status was. I was able to learn more
background information on the education health model, especially for asthma, and how poor
asthma management affect children's performance in school. This article also re-enforced the
idea to have tests to test the participants' knowledge before and after my education pamphlets.

Hu, Hsin, Fe-Lin Lin Wu, and Fu-Chang Hu. "Effectiveness of Education Programs About Oral
Antibiotic Suspensions in Pediatric Outpatient Services." Pediatrics and Neonatology: n.
pag. PubMed. Web. 28 Sept. 2015.
This article from the journal Pediatrics and Neonatology investigates the effectiveness of
different methods of education within an education program for pediatric patients who were
receiving oral antibiotic suspension. The rate of parental error in dosing liquid medications from
powdered form remains high even after verbal instruction. In countries where man power is low
and parents need to administer the medication themselves, educating providers on the proper way
to prepare liquid medications from powder is crucial to the effect of the medication on the
pediatric patient. 150 caregivers participated in the study and were split into three different
groups. The first group received a package insert, the second group received an educational sheet
with pictures, and the third group received the educational sheet along with an in person meeting
with the pharmacist. Each caregiver was given a questionnaire of 12 questions. The results
showed that a face to face education with the pharmacist demonstrated a much more significant
impact on the participants than the educational sheet or package insert.
I can use this article to give me ideas about what the most effective method would be to
use for my project. Because I plan on providing patient education to my mentors pediatric
patients, this study was helpful in showing that a verbal education performed by the pharmacist
is the most effective and timely. This is a good point to consider as I decide how I will educate
patients on their illness and gives me something to discuss with my mentor. Furthermore, I can
experiment by combining an educational sheet with a verbal education as the study did with
group 2 and examine the results. I also found it interesting that many developed countries still
need parents or caretakers to reconstitute medication and the dangers of doing so.

Kercsmar, Carolyn M. "Reduction in Asthma Morbidity in Children as a Result of Home

Remediation Aimed at Moisture Sources." US National Library of Medicine National
Institutes of Health (2006): n. pag. Print.

This article addresses how home dampness and the presence of mold has been associated
with asthma severity. The study examined changes in asthma severity in children as a result of
taking better care of moisture sources within homes. A randomized controlled trial was
conducted on a total of 62 asthmatic children, ranging from 2-17 years old, living in homes with
indoor mold. They received an asthma intervention including an action plan, education, and
individualized problem solving. They also received household repairs, including reduction of
water infiltration, removal of water-damaged building materials, and heating/ventilation/airconditioning alterations. The control group received only home cleaning information. Children in
both groups showed improvement in asthma, and the remediation group had a significant
decrease in symptom after remodeling. After the repairs, the remediation group had a lower rate
of asthma issues compared with control group.
Similar to several other articles I found, this study investigated the effect of certain
household factors on pediatric patients' asthma. It was interesting for me to read about the
different way the people in charge of the study were able to help improve the environment of the
participants, and how much more of a positive difference the people who received these changes
experienced. As I said before for a previous article, this may be a topic that I can address as I
educate parents and even the pediatric patients themselves because it seems to have a significant
effect on the severity of asthma.

Kishk, Omayma Ahmed. Personal interview. N.d.

My mentor graduated college with a bachelor of science in pharmaceutical sciences and
now has a doctorate in pharmacy. She now works as a pediatric clinical specialist at the
University of Maryland Medical Center in Baltimore City.
Dr. Kishk can help me gain access to numerous different sources through both her
connections and own subscriptions and availability to different libraries and databases. She can
also give me information on my topic and educate me in the area of pharmacy. She will work
with me to perfect my final project and give me presentation tips. Through my internship with
her, I can gain knowledge and hands on experience in a hospital.

Kitner, Eileen K. "Effectiveness of a school- and community-based academic asthma health

education
program on use of effective asthma self-care behaviors in older school-age
students." Journal For Specialists In Pediatric Nursing 20 (2015): 62-75. Print.
The purpose of this article from the Journal for Specialists In Pediatric Nursing was to
measure the effectiveness of Staying Healthy-Asthma Responsible & Prepared, which is an
asthma education and counseling program, on aiding in the use of effective asthma selfmanagement behaviors. The study was split into two groups where the participants were not told
what was being tested, and it was a long term study. Two hundred and five parents of fourth and
fifth graders were asked to complete pre-intervention surveys, and then again at time periods of
1, 12, and 24 post intervention. The results exhibited that all students improved in areas of
asthma episode management, risk reduction and prevention, and health promotion behaviors.
Through this article and experiment, it was proven that by working with the school and
academic environment, nurses and physicians were able to decrease the number of asthma
attacks that elementary students (fourth and fifth graders) experience. Similarly, I hope to be able
to see similar results by the end of the year with my brochures/videos that I distribute to both
parents and the patients themselves. I can learn techniques from the intervention program and
look into the Staying Healthy-Asthma Responsible & Prepared counseling program, as well as
others. Because I am concerned about age groups, I can take into account that this study still
gives education to the parents even with fourth and fifth graders.
Kotses, Harry. "Home Monitoring in Asthma Self Management." Journal of Asthma (2006): n.
pag. Print.
This article from the Journal of Asthma delves deeper into the topic of peak flow
monitoring. Peak flow monitoring of asthma emerged with the rise in asthma self-management
programs. Because it offered an objective way to gauge asthma severity, it promised
improvement in the accuracy of asthma monitoring. However, since that has not been fulfilled as
shown by the debate concerning both the degree to which peak flow and symptom scores are
related to one another and on the relative effectiveness of symptom and peak flow monitoring for
asthma management, this study decided to review research relating to these topics. The study
was able to find that the strength of the relationship between peak flow and symptoms is low to
moderate and changes between different people. It was also found that benefits of peak flow
monitoring in asthma self-management provide no more than a small difference in effectiveness
beyond that afforded by symptom monitoring.
Although this article and study does not relate directly with my project or focus for intern
mentor this year, I still found it intriguing to learn about peak flow monitoring as it is a different
and relatively unheard of technique to measure the severity of an individual's asthma. I was able
to see comparisons on the efficacy of both peak flow monitoring and symptoms monitoring and
read on different reasoning on why one or the other was a better choice. Because a multitude of
sources was used within the article, I can now go on those sources and figure out if there will be
any helpful to me.

M. "Randomized trial of a comprehensive asthma education program after an emergency

department visit." Asthma and Immunology (2006): 44-51. Print.
As a result of a great deal of debate on whether emergency department patients will
benefit from education that teaches maximum self management and treatment. In order to further
explore this issue, they conducted a randomized trial of asthma education after a visit to the
emergency department. Patients who present with severe asthma and history consistent with
moderate to severe asthma or recent ED visits were separated by age with either adult or child
and randomly assigned to intervention during the visit to the emergency department. The
intervention was conducted by trained asthma educators and included an office visit with the
primary care physician followed by a home visit. Overall, 39% of the 117 patients assigned to the
intervention group did not follow any of the suggested activities. Subgroup analysis suggested a
greater benefit among children than in adults.
From this article, I was able to gain knowledge that patient education appears to be more
effective for children than in adults, which supports my project in that asthma management can
improve with education to pediatric patients and their caregivers. One of the conclusions of the
study was that further research could be done on other asthma education strategies in order to
reduce the number of emergency department visits and encourages my belief that my intern
mentor project for this year will hopefully greatly benefit the pediatric unit at UMMC and make
the life of my mentor a little less stressful.
McCarty, Kendall, and Jayne Rogers. "Inpatient Asthma Education Program." Continuing Nurse
Education 38.5 (2012): n. pag. Print.
This Inpatient Asthma Education Program was held in one hospital called the Children's
Hospital Boston because asthma was their second leading diagnosis annually. In order to
improve the education of the providers and increase the completion of individualized asthma
action plans, the nurses created a comprehensive asthma education plan based on the 2007
National Heart, Lung and Blood Institute/National Asthma Education and Prevention Program
(NHLBI/NAEPP) guidelines. The program combined several different teaching strategies, and
results demonstrated extreme improvement in understanding of disease and compliance with
creating individual asthma action plans.
This article brought to my attention that individualized action plans would also assist in
improving patient education, and it is something I can talk to my mentor about in the future.
Because this study was performed at a children's hospital, it directly relates to my internship as
we both focus on pediatric patients. I can also look at the various teaching techniques they used
and experiment to see if I should use any of them. The guidelines that they based their education
program off of would most likely be helpful to me as well as I figure out what is appropriate to
put into my pamphlets and/or videos.

"National Center for Biotechnology Information." National Institute of Health. N.p., n.d. Web. 6
Dec. 2015. <http://www.ncbi.nlm.nih.gov/>
The National Center for Biotechnology Information website is supported by the National
Institute of Health, which is the nation's medical research agency. The website consists of
information ranging from research on disease to research on genetics. There are also various
essays, books, and other resources for the topics that are covered, and citations and PDFs are
offered for most of the sources. The purpose of this website is to provide a source of knowledge
for the general public in an expansive number of topics and to act as a reliable place to find
information for a paper or project.
This website will help for the rest of this year throughout my experience in the intern
mentor program because it can be a major source of information and aid for me when I
performing research on asthma and the best methods on helping asthmatic children. I have also
been able to find sources on this website that have assisted me in deciding the age groups that I
would like to focus on for my project this year.
Ortiz. "Asthma diagnosis and management: a review of the updated National Asthma Education
and Prevention Program treatment guidelines." Journal of Academic Physician
Assistants (2009): n. pag. Print.
Because asthma is a common disease where there is chronic inflammation of the airways,
the National Asthma Education and Prevention Program guidelines exist to provide
recommendations for asthma management based on various factors that include the monitoring
of asthma severity and control, patient education, control of environmental factors and comorbid
conditions that may affect asthma, and pharmacologic therapy that may help resolve any asthma
related issues. The purpose behind this article was to review and describe the most noticeable
changes and to provide a summary of the key asthma diagnosis's and management
recommendations in the newly updated 2002 version.
As I read this article, I came to a realization that I could use the National Asthma
Education and Prevention Program guidelines among other guidelines that must exist and pertain
to pediatrics or asthma to improve my project and better my understanding of the area of patient
education. With the recommendations that the guidelines have within
them, I will be able to experiment with different strategies in order to optimize self management
among pediatric patients and also improve the parents' knowledge of the disease.

"Pediatric pharmacy practice guidelines. Pediatric Pharmacy Administrative Group Committee

on Pediatric Pharmacy Practice." American Journal of Health-System Pharmacy: n. pag.
Print.
This article discusses how pediatric patients are unique because of age-specific
differences in their metabolic capacity. It also talks about how there is a lack of published
information on the effects of many new pharmaceutical agents in this age range, new
technological applications, and how changes in population demographics are caused by new
diseases. This article also states that thorough pharmaceutical services are essential for
maximizing the benefit and avoiding any negative effects of pharmacotherapy and new
technologies. These comprehensive pharmaceutical services are said to be able to help optimize
the use of health-care resources in the pediatric age group and assist in the creation,
implementation, and evaluation of new methods of treatment that will hopefully benefit children
around the country.
I have benefited from reading this because it gave me more knowledge on the
pharmaceutical practice, especially in the pediatric field and discussed the major issues that need
to be addressed. The article talks about the importance of pharmacy and the benefits it grants to
the pediatric age range and how it helps with adjusting to new technologies, which further
interests me in having pharmacy as my career. This article was also more general in discussing
new methods of treatment for children, rather than just focusing on asthma which is interesting
after reading so many articles specifically focused on asthma.
Pestinos, Konstantinos. "Level of ParentAsthmatic Child Agreement on Health-Related Quality
of Life." Journal of Asthma 48.3 (2011): n. pag. Print.
Direct assessment of health-related quality of life (HRQL) is necessary to understand
the impact of a disease on patients' well-being and to evaluate clinical interventions. There has
been an ongoing debate in the literature on pediatric health outcomes concerning who is the most
appropriate respondent when assessing children's HRQoL. The purpose of this article was to
evaluate the level of agreement between child self-reports and parent proxy-reports in children
with asthma. 504 children with asthma along with their parents who were referred to outpatient
asthma clinic participated in this study. Subjects were divided into two age groups (47 and 814
year olds). The level of agreement between children and parents was evaluated using intra-class
correlation coefficients and BlandAltman analysis.
I can benefit from this article because it discusses how the quality of life can impact the
patient's well being and the severity of the patient's disease. This study also takes time to specify
the age ranges in each group that was tested which will help me separate my ages for my project
this year. Although I will not be able to use the same technique to analyze my results, it was
interesting to learn about something new such as the Bland-Altman analysis.

"Publications and Databases." American Psychological Association. N.p., n.d. Web. 6 Dec. 2015.
<http://www.apa.org/>
The American Psychological Association is an organization that consists of over 12,000
members and focuses on over 54 fields of psychology. Its goal is to grow as an organization that
helps advance psychology as a science. The members in which the organization is made up of
includes psychologists with doctorate degrees that work in a myriad of settings as well as
psychology students and professionals that work with the subject of mental health. Its resources
include books, videos, databases, journals, etc., and browsing by subjects is offered.
I can use this website in the future if I decide that I need to learn more about the
psychological effects that asthma may have on pediatric patients and relate physical
consequences the patients may suffer from to the mental consequences. The research that is
discussed on this website could also be interesting to include in my project for the older age
groups as they will be able to understand it .
R., Gonzales. "The 'minimizing antibiotic resistance in Colorado' project: impact of patient
education in improving antibiotic use in private office practices." US National
Library of
Medicine National Institutes of Health: n. pag. Print.
This article from the National Library of Medicine NIH assesses the impact of patient
education on prescribed antibiotics for pediatric patients with pharyngitis and adults with acute
bronchitis. The data was collected from a total of four different care organizations in Colorado
during the winters of 2000 and 2001. A controlled trial of patient education in both households
and offices were conducted. The physicians were mailed antibiotic prescribing profiles and also
practice guidelines as part of the improvement program. Office visits were extracted by managed
care organizations using International Classification of Diseases-9-Clinical Modification codes
and merged with pharmacy claims. Antibiotic prescription rates increased from 38 to 39 percent
for pharyngitis at distant practices and decreased from 39 to 37 percent at local practices and
from 34 to 30 percent at intervention practices. Adjusted antibiotic prescription rates decreased
from 50 to 44 percent for adult bronchitis at the distant control practices, from 55 to 45 percent at
the local control practices, and from 60 to 36 percent at the intervention practices
I can use this article for my project this year to see how intervention programs that
focused on patient education can affect prescribed antibiotics for both adults and young children.
It also demonstrates to me how the distance of the offices from the patients can affect the
prescription rates. This study allows me to see the comparison between adults and pediatric
patients and their reaction towards the education given to them.

Rashid, Shumyla. "Effectiveness of a promotora home visitation program for underserved

Hispanic children with asthma." Journal of Asthma 52.5 (2015): n. pag. Print.

This article is mainly about the Breathmobile, a mobile asthma clinic. The objective of
this study in primarily Hispanic-American children was to determine the difference in retention
between those seen in the Breathmobile compared to those receiving an additional home visit.
Children with asthma in the Breathmobile program were evaluated for asthma status. Participants
who required home visits had issues that included poor asthma control and educational and
environmental control needs. An initial visit consisted of a 3-h interactive educational session
covering asthma basics. A follow-up visit 1 month later assessed implementation. A total of 1007
asthmatic children were seen between April of 2002 and June of 2005, 136 of whom received
home visits. These children showed significantly greater retention compared to those without
home visits.
Although this study does not directly relate to my project for this year, it taught me that
direct visits to patients' homes are more effective than just visiting an asthma clinic. This article
also informed me on how they evaluated the asthma status of patients. Because the children
showed greater retention with home visits, I could look into more direct strategies, so that my
pediatric patients will be able to retain the most information.

"Recommendations for Meeting the Pediatric Patient's Need for a Clinical Pharmacist: A Joint
Opinion of the Pediatrics Practice and Research Network of the American College of
Clinical Pharmacy and the Pediatric Pharmacy Advocacy Group." The Journal of Human
Pharmacology and Drug Therapy 33.2: n. pag. Print.
This article from The Journal of Human Pharmacology and Drug Therapy combines the
opinions of pediatric practice and The American College of Clinical Pharmacy Pediatrics
Practice and Research Network (ACCP Pediatrics PRN). ACCP Pediatrics PRN released an
opinion paper in 2005 with recommendations for improving the quality and number of pediatric
pharmacy education in pharmacy colleges, residency programs, and fellowships. The purpose of
this paper was to outline both strategies and recommendations for expanding the quality of
pediatric clinical pharmacy practitioners by increasing the expectations of pharmacists entering
pediatric practice, standardizing pediatric pharmacy education, and expanding the current
number of pediatric clinical pharmacists. These recommendations were written down in a paper
in order to possibly provide both a conceptual framework for schools of pharmacy, health care
systems, and policymakers.
Through this article, I gained insight on the type on changes that the American College
recommended to be implemented in not only pharmacy colleges, but also residency programs
and fellowships. From this information, I was able to get a glimpse of what may occur in the
future when I attend pharmacy college, if some of these recommendations have not already been
established. This article also explained to me that there is still a lack of pharmacy general
practitioners which is a good sign for me and my future plans.

Santos, Aliny De Lima. "How People with diabetes evaluate participation of their family in their
health care." Journal of Asthma: n. pag. Print.
The objective of this article was to better understand how individuals with diabetes
evaluate the participation of their family in their health care. This was a qualitative study with 26
individuals in the Diabetes Association of Maring. Of those 26 participants were 9 women and
17 men (38 to 83 years) who had attended at least one educational meeting of the culture
circles of the association. They turned to the reference of Paulo Freire by implementing an
educational proposal directed at people with type 2 diabetes mellitus that surpassed the
limitations of common health education approaches. Opinions were given in meetings and were
then recorded and analyzed according to different themes. Three main themes were found:
recognizing the importance of family in the care of patients with diabetes, blaming the family for
non-adherence to healthy practices, and feeling a gain from the disease by feeling cared for by
family members.
One of my underlying goals for this year is to be able to increase the quality of care that
providers are able to give to their children through patient education and helping them better
understand how to properly manage the disease and what they can do to improve their children's
experience with asthma. Despite the fact that this article is on diabetes, I learned that the actions
of the patient's family did have a significant impact on the patient, whether it be positive or
negative. Being well cared for by the family members or caretakers may also help the patient feel
more positive about their disease and their ability to overcome it.
"Stepwise management of asthma." US National Library of Medicine National Institutes of
Health: n. pag. Print.

This article discusses the topic of stepwise management of asthma, which is an important
area with several recent guidelines recommending management. This is a review of published
English language literature that focuses on management guidelines for asthma in both adult
and pediatric patients. These guidelines appear to aid risk reduction, leading to a decreased
number in emergency room visits and preventing loss of lung function in adults and lung growth
in children. Asthma management guidelines consist of 4 components of asthma care including:
monitoring of severity of asthma, patient education, controlling external triggers, and
medications, including medication adherence. The cost of asthma is also a topic that is discussed
within this article.
By reading more in depth on these guidelines for managing asthma, I am able to gain
more information on what to teach my pediatric patients and their caretakers in order for them to
manage their disease correctly. Because these guidelines have proved to have positive results in
decreasing emergency department visits as well as other common issues, I know that they are
reliable and have been effective. The cost of asthma is a common problem experienced by
families with lower income, so I could possibly research on more cost friendly strategies to help
them manage their child's asthma.

Thacher, Jesse D. "Pre- and Postnatal Exposure to Parental Smoking and Allergic Disease
Through Adolescence." Journal of the American Academy of Pediatrics: n. pag. Print.
The purpose of this article from the Journal of the American Academy of Pediatrics was
to examine the role of prenatal and postnatal second-hand tobacco smoke (SHS) exposure
on asthma, rhinitis, and eczema development up to 16 years of age. A group of 4089 children was
followed for 16 years. Information on parental smoking habits, lifestyle factors, and symptoms of
allergic disease was gathered using questionnaires given to parents. The study was able to find
that early SHS exposure, in utero or during infancy, influences the development of allergic
disease up to adolescence.
This article educated me in how the actions of the parents, in the area of smoking, can
affect children from utero to adolescence. I have seen cases in the Pediatric Intensive Care Unit
where children cannot receive the care they need because of irresponsibility on the parent's side.
Those situations sadden me because those children's lives are put at risk because of someone
else's decisions, and this study directly supports my feelings. It was extremely intriguing to find
that second hand smoking could affect that development of allergic disease up to childhood.
Tulloch, Joanie, et al. "Evaluation, modification and validation of a set of asthma illustrations in
children with chronic asthma in the emergency department." Canadian Respiratory
Journal: n. pag. US National Library of Medicine National Institutes of Health. Web. 28
Sept. 2015.
This article from the Canadian Respiratory Journal explains a study that tests, modifies,
and validates a set of illustrations that depict different levels of asthma control and common
triggers in pediatric patients. 15 different illustrations were shown to a total of 80 patients in the
Emergency department at the Childrens Hospital of Eastern Ontario, Ottawa, Ontario. The
effectiveness and comprehensiveness of the illustrations were tested through a questionnaire and
interview with children from ages 10-17 and the parents of children ages 1-9. The results
demonstrated that seven out of the fifteen illustrations needed modifications in order to be easier
to understand. The illustrations were then modified based on key concepts brought up by the
patients and incorporated into a child friendly asthma plan that allows the child to begin to self
manage his or her asthma.
This article is helpful to me because it shows that there are many illustrations on
pamphlets that are still in need of modification, and that there are multiple ways in which
different illustrations can be made simpler. Because I am planning to have some type of
pamphlet as a part of my patient education project, it is helpful to know that I could perform a
similar type of investigation on a smaller scale in order to make sure that the illustrations and
pictures on my brochure are clear and can effectively aid children in beginning to better
understand their problems and managing them. This could polish up my project and show the
progression from my first brochure to my final one.

Wang, Elizabeth Wenqian. Personal interview. 9 Oct. 2015.

Dr. Wang graduated college with a bachelor of science degree in molecular cellular
biology with a minor in mathematics and received her medical doctor degree from the University
of Michigan. She is now an internal medicine hospitalist at the University of Maryland Medical
in Baltimore City.
Being an internal medicine doctor, Dr.Wang can help me gain a different perspective in
the world of asthma as she deals with adult asthma patients. Because my project is on patient
education, she can also give me input on the alternate techniques she uses to educate her patients
on how to manage their asthma. Even though I plan to go into pharmacy, being able to get a
glimpse of another area in the medical field will be both helpful and interesting for me. She can
look at my final project and give me any criticism she has. Through my relationship with her, I
can gain knowledge from a different field.
Weicha, John M. "Evaluation of a web-based asthma self-management system: a randomised
controlled pilot tria." US National Library of Medicine National Institutes of
Health (2015): n. pag. Print.

The purpose of this study was to create a website called BostonBreathes. This website
was created to intervene with asthma management on several different levels and was evaluated
in this study. It was also developed to raise awareness about adherence to asthma medications, to
improve communication between patients and their providers, and to provide primary care
providers with recent symptom information and data on medication use. 58 children with
moderate asthma were randomized to either usual care or use of BostonBreathes. Subjects
completed asthma education activities and reported their symptoms and medication use. Primary
care providers monitored their patients website use, their reported symptoms and medication
use, and were able to communicate online via a discussion board with their patients and with an
asthma specialist. After 6-months, reported wheezing improved significantly in both intervention
and control groups, but there were no significant differences between intervention and control
groups in these measures. Frequency of emergency room visits did not significantly change in
either group. Knowledge of the purpose of controller medicine increased significantly in the
intervention group.
By reading this article, it opened my eyes to another way to promote patient education:
through a website. The topics that the website was created for to raise awareness about such as
adherence to asthma medication are also topics that I will most likely focus on in my project for
this year. Both the sample size and time periods used for this study can also be applied to my
project for this year, and I can use this study for ideas on how to get my message across to
pediatric patients. This investigation also demonstrated that patient education has a positive
influence on pediatric patients asthma-related knowledge and use of asthma preventer
medications.

Yeatts, Karin, Deidre Washington, and Betsy Sleath. "Communication and Education About
Triggers and Environmental Control Strategies During Pediatric Asthma Visits." HHS
Author Manuscripts: n. pag. US National Library of Medicine National Institutes of
Health. Web. 28 Sept. 2015.
This article from the US National Library of Medicine database aims to determine the
extent to which pediatric asthma patients discuss different triggers of asthma and the role that
providers play in which triggers are talked about the most. 296 pediatric patients from the ages 8
to 16 were gathered in North Carolina and asked to answer a questionnaire. The results exhibited
that the most common topics brought up by patients as factors were weather, allergies, and
exercise while environmental control strategies were brought up much less, only 27% of the
time. Likewise, providers or pharmacists talked about these strategies less as well, only focusing
on them during patient education 14% of the time. The study was able to conclude that despite
the fact that pharmacists still provide a sufficient amount of education on environmental control
strategies and other topics, they can still go more in depth, which may result in a decline in the
worsening of asthma in patients.
I can use this article for my internship this year because it enlightened me on an area that
is typically focused on less and deserves more attention. As a result of reading this article, I can
look for other information that tells me what patients should learn more about during patient
education and add more details about those topics to my pamphlet or video. I can also tell my
mentor about it and ask her to speak about them with her pediatric patients more and observe the
effect.