Changes in clinical conversations when providers are informed of asthma patients' beliefs about medication use and integrative medical therapies

Objectives: To explore whether patient's personal beliefs about inhaled corticosteroid (ICS) and integrative medicine (IM) are discussed at routine primary care visits for asthma. Background: Negative medication beliefs and preferences for IM can be salient barriers to effective asthma self-management. Method: A qualitative analysis of transcripts from 33 audio-recorded primary care visits using conventional content analysis techniques. Results: Four themes emerged when providers had knowledge of patient's beliefs: negative ICS beliefs, IM use for asthma, decision-making and healthy lifestyles. Two themes were identified when providers did not have this knowledge: asthma self-management and healthy lifestyles. Conclusion: When providers had knowledge of their patient's IM endorsement or negative ICS beliefs, they initiated conversations about these modifiable beliefs. Without training in IM and in effective communication techniques, it is unlikely that providers will be able to effectively engage in shared decision-making aimed at improving asthma self-management.