Krupa Sekhar ’25 spent this summer season researching adherence to bronchial asthma inhaler medicine in India beneath the Laidlaw Research and Scholarship Program, merging her pursuits in well being fairness, drugs and social justice.
Since its inauguration in 2021, the Laidlaw Program has hosted two cohorts. The program is split throughout two summers and offers scholar leaders with a six-week funded analysis challenge, management improvement coaching, a global leadership-in-action program and community of world students.
During her six weeks in Bangalore, India, Sekhar carried out observational and oral surveys on about 80 mother and father of pediatric bronchial asthma sufferers beneath the steerage of pulmonologist Dr. Bharath Reddy on the Shishuka Children’s Specialty Hospital. This hospital was chosen for its broad illustration of affected person socioeconomic standing.
The survey, typically translated into the town’s official language Kannada, included questions on mother and father’ perceived and precise understanding of bronchial asthma.
Parents had been requested about frequent bronchial asthma misconceptions, such because the addictiveness and hazard of the inhaler steroid therapy, to find out their precise understanding of bronchial asthma.
Parents had been additionally requested to mark their stage of settlement on statements equivalent to on how COVID-19 affected their want to adjust to the therapy, sources that helped them perceive the therapy and the way a lot they trusted their physician. Answers to those questions helped them perceive how these exterior elements could also be correlated with bronchial asthma therapy perceptions.
The surveys had been analyzed utilizing a logistic regression on R software program. The outcomes confirmed that there isn’t a vital correlation between perceived and precise understanding of bronchial asthma, that means some mother and father believed that they had a robust understanding of the illness but in addition believed many misconceptions to be true.
However, it was discovered {that a} good perceived bronchial asthma understanding was correlated with improved bronchial asthma adherence.
Sekhar was interested in why mother and father had perceived understanding of bronchial asthma. Analysis of the survey outcomes revealed a correlation between the doctor-patient-parent relationship and perceived bronchial asthma understanding, indicating that medical doctors should foster belief with the affected person and dad or mum in order to enhance bronchial asthma therapy adherence.
“It’s kind of a linear relationship where if you build a good relationship with the child’s parents and the child, as a doctor you explain asthma while you make them feel seen and heard, then they will have a good perceived understanding of asthma, which then makes them want to adhere with the child’s treatment more,” Sekhar stated.
Unlike the American medical system, Bangalore-based sufferers spend about 5 minutes with their doctor, Sekhar explains, so patient-centered care is much less of a precedence.
“There isn’t much emphasis on fostering relationships and building trust because [they] can’t really do that when [they] have so many patients to see,” Sekhar stated.
Another barrier to fostering significant relationships with medical doctors, sufferers and their mother and father are adverse evaluations in regards to the physician in the neighborhood, which place sufferers at an preliminary place of doubt.
However, Sekhar additionally acknowledged distinctions between American and Indian hospital programs.
“Even if you can’t afford much [in India], you can go to government hospitals and get really good care,” Sekhar stated. “The US healthcare system, where everyone has to deal with insurance…there is Medicaid, but it doesn’t cover nearly enough for families who need it.”
Sekhar hopes to discover ways to use her analysis with Laidlaw and Dr. Reddy to begin enhancing bronchial asthma therapy adherence.
Based on previous related literature, she defined that collaborative and conversational decision-making might be efficient.
“[Doctors are working on] making the parent feel like their input is valued, and that they’re involved in their child’s health care decisions,” Sekhar stated.
Sekhar will current her challenge, together with different Laidlaw Scholars, on the Laidlaw Symposium on Sept. 28 in the Physical Sciences Building.
