I recently had a really rewarding patient experience on the wards. I had a 7 year old patient with severe asthma, eczema and allergies. She’d already been admitted once while I was on service and was back a mere 2 weeks later with yet another asthma exacerbation.

At the last visit we had prescribed her with a low dose daily controller steroid to prevent future flares as well as an albuterol rescue inhaler to use in case of symptoms like wheezing and shortness of breath. To our surprise she had bounced back in respiratory distress triggered by a cold.

This shouldn’t have happened.

As we admitted the patient it was clear that the major barrier to getting her asthma under control was medication compliance, i.e. taking her medications as prescribed. This patient, let’s call her Claire, should have been using her inhaler while sick and taking her daily controller steroid.

She wasn’t.

Her mom had had difficulty filling her prescriptions after the first discharge 2 weeks ago and also didn’t understand why her daughter needed to be on so many medications in the first place.

Once we got Claire’s asthma under control, I took the time to to do teaching with mom before discharge. One of my chief residents gave me a rundown on how to explain asthma to families.

I broke down what actually happens in the body during and asthma attack and the role each medication plays in combatting these events. Then I explained the role of Claire’s daily controller medication in reducing the severity of future attacks and the importance of taking the medication even when she wasn’t having symptoms. Then finally we discussed what to do when Claire was having symptoms and when to come into the Emergency Department.

By the time I finished explaining and answering questions, Claire’s mom expressed so much relief and gratitude. She said no one had ever broken down Claire’s asthma or the medications that she was prescribed and that she finally understood and felt empowered. She said she’d never been this excited to give medications before, haha.

It felt so good to know that something as small as a talk could empower Claire’s mom and possibly change the trajectory of asthma exacerbations in the future.

I plan to continue giving this talk to all my asthma patients.