Pediatric asthma: low-literacy action plan boosts parental knowledge of medication use

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  • Compared with parents using a standard written action plan (SWAP), those using a low-literacy plan (LLP) had better knowledge of medication use. 

Why this matters

  • LLP should be implemented as part of routine practice.

Key results

  • LLP parents were less likely to answer incorrectly regarding medications to be used everyday and when sick (adjusted OR [aOR], 0.5; P=.03). 
  • Few parents in both groups made errors regarding giving albuterol when the child was sick (7.0% vs 10.3%; P=.5). 
  • Almost a third in both groups made errors regarding the use of preventative medications on days when the child was sick (fluticasone: 32.0% vs 32.0%; P=1.0, montelukast sodium: 41.0% vs 44.3%; P=.7). 
  • LLP parents were less likely to make errors in relation to spacer use (aOR, 0.1; P<.001). 
  • Nearly half of parents in both groups answered incorrectly in relation to appropriate emergency response (43.1% vs 48.1%; P=.5). 
  • When comparing plans, 70.6% of LLP parents and 82.1% of SWAP parents found the LLP easier to understand (P=.07).

Study design

  • Randomized controlled study of LLP (n=109) vs SWAP (n=108) for parents of children with asthma aged 2-12 y. 
  • Funding: KiDS of NYU Langone Foundation.


  • Use of hypothetical scenarios. 
  • May not be generalizable.