Exploring the perception and the needs of pharmaceutical care perceived by family caregivers of pediatric asthma patients in Guangdong Province, China: a cross-sectional survey study

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The aim of this study is to investigate the level of understanding of asthma among family caregivers, the burden they facing in caring for children with asthma, and their needs of pharmaceutical care. Methods : A questionnaireinformed by recent literature was distributed to family caregivers of children (<18 years old) diagnosed with asthma from Guangdong Province, China. Multiple linear regression analysis was used to identify the factors associated with the caregivers’ need of pharmaceutical care. Results : A total of 610 valid questionnaires were collected. Most of the participants were women (60%) or aged between 35 and 44 years (48%). Only 38.9% of participants believed that they had good asthma related knowledge. There were 59.2%of participants bearing high burden due to pediatric asthma, and 54.9% of the participants indicated great need for pharmaceutical intervention. The results of multiple linear regression showed that pharmaceutical care needs were significantly associated with their gender, age, duration of taking care of pediatric asthma patients, and overall burden (all p <0.05). Conclusions : Caregivers of pediatric asthma patients self-reported inadequate levels of asthma knowledge, high level of burden, and unmet needs for pharmaceutical care, all of which presented great opportunities for pharmacists to contribute to pediatric asthma management at the community level. asthma pharmaceutical care pediatrics family caregiver survey Figures Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 Background Asthma is a heterogeneous disease usually characterized by chronic airway inflammation. The symptoms include wheeze, shortness of breath, chest tightness, and cough 1 . Asthma is one of the most common chronic diseases in childhood, affecting approximately 10% of children worldwide 2 . The Global Burden of Disease Study (GBD) estimated that in 2019, asthma caused 21.6 million disability adjusted life years (DALYs) across all ages globally and was ranked 34th among the causes of burden of disease 3 . A retrospective study showed that in China, the annual cost of mild, moderate, and severe pediatric asthma patients aged 6 to 14 were CNY 1,094, CNY 1,660 and CNY 3,020 respectively, placing a heavy economic burden on the healthcare system. 4 . Between 1990 and 2020, the prevalence of pediatric asthma in China has increased in both sexes 5 . A study conducted in 30 cities in China showed that according to the asthma control level classification defined by Global Initiative for Asthma (GINA), the overall control rate of asthma in urban areas of China was only 28.5% 6 . Another study found that asthma control was positively correlated with positive parenting style, thus healthcare professionals should encourage parents to cultivate positive parenting style 7 . For pediatric asthma management, pharmacists can improve the level of parental knowledge through patient training and counseling, thereby improving the control of pediatric asthma 8 . To the family caregivers, caring for a child with asthma is challenging 9 . Adequate support to help them adapt and cope with the challenges is prominent. The current literature has detailed how family caregivers experienced anxiety about their children' s health, and their lack of knowledge about the disease, as well as uncertainty about management and prognosis 10 – 11 . A common conclusion drawn from the current studies suggests the need for supporting management of pediatric asthma by health professionals, particularly as healthcare becomes more patient-centered. Community pharmacists are an integral part of the health care team in the primary care setting and are one of the most easily accessible healthcare providers 12 . In pediatric asthma management, community pharmacists can provide long-term follow-up care, including disease screening, disease knowledge education, medication adherence education, etc 13 . The advantage of community pharmacists is that they are distributed around the patient's living area, able to fully interact with patients. Many studies have demonstrated that pharmacist interventions can benefit pediatric asthma patients in improving asthma control, pulmonary function, medication adherence, inhaler technique, quality of life, etc 14 – 19 . Despite the emerging studies focusing on pharmaceutical services for pediatric asthma, much of the current literature focused on the interventional effects. There is still a lack of research on the pharmaceutical care needs of pediatric asthma patients/caregivers. Considering the enormous burden of pediatric asthma in China, this study aims to explore the level of understanding of asthma among family caregivers, the burden they faced in caring for children with asthma, and their needs of pharmaceutical care in Guangdong Province, China. Methods Study Design and Participants This was a cross-sectional survey-based study. Family caregivers of pediatric asthma patients living in Guangdong Province were eligible for inclusion in the study. The data was collected from January to April 2024 using convenience sampling. The valid sample size for this study was determined at a minimum of 384 (confidence level 95%, margin of error 5%). An invitation to complete the online survey in this study was extended to the caregivers through the outpatient clinic in a tertiary hospital, social media and patient/caregiver chatgroups. All information was collected anonymously. The first page of the questionnaire included the participation information statement, followed by the agree/disagree options at the end of the page. Those who agreed to participate in the study navigated to the questionnaire when they clicked the agree button. Questionnaire design The design of the questionnaire was based on a previous literature review on pharmacist intervention for pediatric asthma 20 . The questionnaire consisted of 5 sections, including participant qualification confirmation (1 question), demographics (9 questions), caregivers’ perception of asthma-related knowledge (19 questions), the burden on caregivers due to pediatric asthma (5 questions), and their needs of pharmaceutical care provided by community pharmacists (12 questions). Participants could review and change their answers at any time through the "Previous" button. Prior to the official distribution of the survey questionnaire, a pilot study was conducted to solicit opinions on the appropriateness of the content and wording of the questions. To this end, 26 family caregivers were recruited. They read the entire questionnaire and raised any doubts about the questions asked. All items in the survey were retained, but some question expressions were modified to facilitate understanding. The reliability and validity test results showed that, Cronbach’s alpha was acceptable for those subscales (Cronbach's α > 0.5), and the Kaiser-Meyer-Olkin value of 0.875 indicated a highly acceptable score with a significant Bartlett's test of sphericity ( p < 0.05). Ethical approval The study was reviewed and approved by the University of Macau research committee from the school of Institute of Chinese Medical Sciences (Ethics Assessment ID: SSHRE23-APP071-ICMS). Consent and confirmation were obtained at the beginning of the questionnaire. Statistical analysis Excel and IBM SPSS version 24.0 were used for data analysis. Descriptive statistics were use to describe the demographic characteristics, caregivers’ perception of asthma-related knowledge, the burden on caregivers due to pediatric asthma, and needs of pharmaceutical services provided by community pharmacists. Frequencies and percentages were calculated for demographic data. For the perception of asthma-related knowledge data, the maximum score was 95 points. The respondents were assigned to three groups: low knowledge, 0-28 points (70%). For the burden on caregivers due to pediatric asthma data, the maximum score was 25 points. The respondents were assigned to three groups: low burden, 0-7 points (70%). For the needs of pharmaceutical care provided by community pharmacists data, the maximum score was 60 points. The respondents were assigned to three groups: low level of needs, 0-17 points (70%). The range was based on the literature recommendations 21 . The Kolmogorov–Smirnov test was performed to test data normality. Univariate analyses were performed using the Mann–Whitney U or Kruskal–Wallis test for continuous variables with non-normal distribution. Correlation analyses were performed using Spearman’s correlation coefficient. A generalized linear regression model was developed to understand which factors were associated with pharmaceutical care needs by family caregivers of pediatric asthma patients due to non-normally distributed data. Statistical significance was considered for p -values <0.05. Results Demographic Characteristics A total of 787 family caregivers participated accessed this online survey, of whom 610 completed it, given a completion rate of 77.5%. As shown in Table 1, 60% of the participants were women. The vast majority of the participants aged between 35 and 44 years (48%). Almost all questionnaires were completed by the parents of pediatric asthma patients (99.3%). More than 98% of participants were taking care of one pediatric asthma patient. Approximately 14% of participants had been caring for pediatric asthma patient(s) for less than 6 months, while around 41% of participants more than 2 years. Among children with asthma taken care of by participating family caregivers, the proportion of asthma patients aged 3 to 9 was the highest, accounting for 51.2%. The proportion of boys (60%) was higher than that of girls (40%). Most pediatric asthma patients experienced intermittent(51.5%) or mild persistent (36.1%) asthma severity. Table 1. Demographics characteristics of participants (n=610) Demographic characteristics Cases % Gender Female 366 60.0% Male 244 40.0% Age (years) 25-34 280 45.9% 35-44 293 48.0% 45-54 36 5.9% 54+ 1 0.2% Relationship with pediatric asthma patients Parents 606 99.3% Grandparents 4 0.7% Number of pediatric asthma patients taking care of 1 602 98.7% 2 8 1.3% Duration of taking care of pediatric asthma patients < 6 months 84 13.8% 6-12 months 99 16.2% 1-2 years 177 29.0% 3 years or above 250 41.0% Age of your pediatric asthma patients (years) # <3 48 7.8% 3-6 161 26.1% 7-9 155 25.1% 10-12 138 22.3% 13- <18 116 18.8% Gender of your pediatric asthma patients # Female 247 40.0% Male 371 60.0% Severity of asthma experienced by the child(ren) in the past 6 months # Intermittent state* 318 51.5% Mild persistent** 223 36.1% Moderately persistent*** 66 10.7% Severe persistent**** 11 1.8% # 8 of the participants reported having to take care of 2 children with asthma so the total number of children was 618. *Intermittent state: asthma symptoms less than once a week, brief onset, nocturnal asthma symptoms less than or equal to twice a month; **Mild persistent: asthma symptoms more than or equal to once a week and less than once a day, asthma symptoms may affect activity and sleep, nocturnal asthma symptoms more than twice a month and less than once a week; ***Moderately persistent: asthma symptoms appear daily, affect activity and sleep, nocturnal asthma symptoms more than or equal to once a week; ****Severe persistent: asthma symptoms appear daily, and frequent occur, nocturnal asthma symptoms appear frequently, physical activity is limited. Perception of self-reported asthma-related knowledge perceived by family caregivers of pediatric asthma patients Perception of asthma-related knowledge perceived by family caregivers of pediatric patients with asthma was showed in Figures 1 to 4. Overall, 38.9% (n=237) of the participants believed that they had good asthma related knowledge, 61.0% had moderate knowledge (n=372) and 0.2% (n=1) had poor knowledge. Non-pharmacological interventions In terms of non-pharmacological interventions, caregivers believed that they had the least knowledge of peak expiratory flow meters, with only 40% of caregivers believing they knew how to use peak expiratory flow meters. In addition, caregivers were not familiar with what vaccines pediatric asthma patients should receive, with 49% of caregivers believing they had relevant knowledge about vaccination vaccine in pediatric asthma patients. Relatively, parents believed they had a greater understanding of how to ensure children’s mental health (60%) and lifestyle precautions (57%). Figure 1. Perception of non-pharmacological interventions by family caregivers of pediatric patients with asthma Disease management In terms of disease management, only 41% of caregivers believed that they had knowledge about the use of preventive drugs under seasonal changes and other reasons. Besides, 20% of caregivers believed that they did not know when to use relievers and did not know how to respond to exacerbations. Figure 2. Perception of disease management by family caregivers of pediatric patients with asthma Medication use In terms of medication use, caregivers believed that they had the least knowledge of the inhaler use, with only 41% of caregivers believing they knew how to use inhalers. Besides, caregivers believed that they had little understanding of the side effects and drug interactions of medications. There were 27% of caregivers who believed they had poor knowledge about side effects of medicines, and the proportion of caregivers who believed that they had poor knowledge about drug interactions reached 29%. Figure 3. Perception of medication use by family caregivers of pediatric patients with asthma Disease knowledge In terms of disease knowledge, there were 21% of caregivers believed that they did not know what the risk factors of exacerbations in pediatric asthma patients were. Figure 4. Perception of disease knowledge by family caregivers of pediatric patients with asthma Burden of family caregivers due to pediatric asthma The result of the burden of family caregivers due to pediatric asthma was shown in Figure 5. Overall, 59.2% (n=361) of the participants believed that they bore a high burden, 40.5% bore a moderate burden (n=247) and 0.3% (n=2) bore a low burden. Especially with the greatest psychological burden, 70% of caregivers expressed concern about their children suffering from asthma. In addition, 59% of caregivers reported that their child/children's asthma had a negative impact on their quality of life. More than 60% of caregivers indicated that they needed more support from healthcare professionals. Figure 5. Burden of family caregivers due to pediatric asthma Needs of pharmaceutical care by family caregivers of pediatric patients with asthma The results on the needs of pharmaceutical care by family caregivers of pediatric patients with asthma were shown in Figure 6. Overall, 54.9% (n=335) of the participants had a high level of need for pharmaceutical care and 45.1% (n=275) had a moderate level of need. For pharmaceutical care provided by community pharmacists, caregivers had the highest demand for asthma disease education and the lowest demand for psychological counseling and suggestion on asthma therapeutic regimens. Figure 6. Needs of pharmaceutical care by family caregivers of pediatric patients with asthma Factors associated with pharmaceutical care needs Univariate analyses were conducted to determine the association of participants’ gender, age, durations of taking care of pediatric asthma patients and the severities of asthma experienced by the child(ren) in the past 6 months with the mean score of pharmaceutical care needs by family caregivers of pediatric asthma patients, respectively. The results revealed significant differences in the mean score of pharmaceutical care needs by family caregivers of pediatric asthma patients of different genders, durations of taking care of pediatric asthma patients and severities of asthma experienced by the child(ren) in the past 6 months ( p < 0.05). Correlation analyses revealed there was a significant correlation between the mean score of burden of family caregivers due to pediatric asthma and the mean score of pharmaceutical care needs by family caregivers of pediatric asthma patients ( p < 0.05). Generalized multiple linear regression was presented in Table 2, which showed the dependent variable pharmaceutical care needs demonstrated significant associations with the independent variables: male (B = -0.145, p = 0.001), age (B = 0.014, p = 0.001), duration of taking care of pediatric asthma patients less than 6 months (B = 0.215, p = 0.004), and the mean score of burden (B = 0.332, p = 0.000). Table 2. Generalized multiple linear regression analysis between various factors and mean score of needs of pharmaceutical care by family caregivers of pediatric patients with asthma Variables B 95%CI p Lower Upper Gender Female Ref Male -0.145 -.230 -.061 0.001* Age (years) 0.014 0.006 0.023 0.001* Duration of taking care of pediatric asthma patients < 6 months 0.215 0.071 0.360 0.004* 6-12 months 0.109 -0.021 0.238 0.100 1-2 years 0.039 -0.070 0.147 0.483 3 years or above Ref Severity of asthma experienced by the child(ren) in the past 6 months Intermittent state 0.157 -0.159 0.473 0.331 Mild persistent -0.056 -0.371 0.258 0.725 Moderately persistent -0.052 -0.378 0.274 0.754 Severe persistent Ref Average score of burden 0 .332 .263 .402 .000* *: p <0.05 Discussion This study is one of the very few studies that investigated the challenges and burden faced by family caregivers of pediatric asthma patients, and their needs of pharmaceutical care provided by community pharmacists. The survey results showed an insufficient asthma-related knowledge perceived by family caregivers of pediatric patients with asthma (38.9%), a high burden of family caregivers due to pediatric asthma (59.2%), and a high level of need for pharmaceutical care provided by community pharmacists (54.9%). In addition, a positive association was identified between female, older age, duration of taking care of pediatric asthma patients less than 6 months, and higher burden with the needs of pharmaceutical care needs by family caregivers of pediatric asthma patients. Overall, these findings revealed the necessity of further leveraging the role of community pharmacists to support family caregivers in better caring for children with asthma and helped inform the potential contributions of community pharmaceutical care to pediatric asthma management. The findings that family caregivers considered they lacked sufficient understanding of asthma related knowledge is consistent with other recent similar studies. A study in Jeddah found that parents had myths about asthma and the proportion of parents with correct understanding of various asthma knowledge ranged from 56.0% to 88.7% 22 . Similarly, a study in Saudi Arabia also found the total knowledge score for the caregivers ranged from 43 to 64 (total score: 85) 11 . Related studies also reported that only 32% of the caregivers of asthmatic children had adequate knowledge of asthma in Indian 23 . This study reiterated that family caregivers of asthmatic children had insufficient knowledge about asthma in China. A noteworthy finding is that family caregivers had the least understanding about the use of preventive drugs under seasonal changes and other reasons (41%), which was very unfavorable for the prevention of acute attacks in pediatric asthma management. Besides, the proportion of caregivers who understood the risk factors of exacerbations was also relatively low (50%). Asthma attacks often require hospitalization for treatment, which brings significant burden to patients and families 24 . While developing treatment methods for acute exacerbation 25 , it is also crucial to promptly identify children with asthma at risk of exacerbation, as proactive measures can be taken to prevent these attacks 26 . A multicenter clinical trial study showed that preseason treatment could reduce autumn asthma attacks 27 , which is an important reminder that community pharmacists could provide to the caregivers of the pediatric asthma patients. It is a common consensus that pediatric asthma imposes a significant burden on caregivers. An integrative review of 80 studies indicated that family caregivers of pediatric asthma patients faced significant psychological burden, including decreased mental health, quality of life, sleep, family stress, etc. and socioeconomic burden, including poor access to care, work and financial challenges 10 . Given that asthma is a chronic disease that requires long-term monitoring and management, family caregivers need to spend substantial effort taking care of their children, especially paying attention to acute asthma attacks caused by seasons, allergens, and other factors 28 . This brings a significant psychological burden to family caregivers. A study showed that getting more support from pharmaceutical care provided by pharmacists is beneficial for controlling childhood asthma and reducing the economic burden on family caregivers 16 . To our knowledge, there are currently few studies exploring the needs for pharmaceutical care from the perspective of caregivers/pediatric asthma patients. A comprehensive understanding of the unmet needs of family caregivers/pediatric asthma patients is necessary to develop a community pharmacist led pharmaceutical care plan for children with asthma. The findings of this study indicated that family caregivers had a high level of need for community pharmacists to provide disease education, dispense asthma medications, guide the use of inhaled medications, and emphasize the importance of adherence to asthma treatment. Existing studies research suggested that community pharmacist interventions could improve patients’ asthma knowledge, inhaler technique, and medication adherence 14-17 . The results of this study showed that pharmaceutical care needs by family caregivers of pediatric asthma patients were independently correlated with gender, age, duration of taking care of pediatric asthma patients, and average burden. Family caregivers with insufficient understanding of asthma related knowledge will undoubtedly require related information from healthcare professionals such as community pharmacists 29 . For caregivers who take care of pediatric asthma patients for less than one year or have insufficient understanding of asthma, they need more attention and pharmaceutical care provided by community pharmacists 19 . A survey in China showed that community pharmacists’ practice in pharmaceutical care needs improvement 30 . On the one hand, community pharmacists need to improve their understanding and practice of pharmaceutical care 30 . On the other hand, the results of a qualitative study in China revealed that consumers' previous experiences in community pharmacies were far from satisfactory, leading to a general lack of trust in the certification and qualifications, knowledge, communication skills, and attitude of community pharmacists 31 . This study indicated that family caregivers of pediatric asthma patients had a significant demand for pharmaceutical care of community pharmacists. Therefore, in the future, it is necessary to enhance the knowledge of community pharmacists about chronic diseases such as asthma through training and other methods and thus better provide pharmaceutical services for pediatric asthma patients. However, it is worth noting that this study also has certain limitations. This study only collected questionnaires in Guangdong Province. Future studies should draw nationally representative population sample. In addition, family caregivers were free to participate and complete the questionnaire. Therefore, it cannot be ruled out that this self-selected sample may inevitably generate sampling bias. Moreover, the caregiver's understanding of asthma related knowledge analyzed in this study was based on the responses to the questionnaires, and there may be recall bias. In order to gain a more objective understanding of caregiver's asthma knowledge, observational studies can be conducted in the future. Conclusion Pediatric asthma brings a significant burden to families, and many caregivers may not have sufficient understanding of asthma. More attention should be paid to caregiver’s needs for pharmaceutical care and try to meet their needs. In the future, it is necessary to fully leverage the role of community pharmacists and improve China's primary healthcare system to meet the pharmaceutical care needs of caregivers for pediatric asthma patients and provide better management for pediatric asthma patients. List Of Abbreviations GBD Global Burden of Disease DALYs Disability adjusted life years GINA Global Initiative for Asthma Declarations Ethics approval and consent to participate The study was approved by the University of Macau research committee from the school of Institute of Chinese Medical Sciences (Ethics Assessment ID: SSHRE23-APP071-ICMS). All methods in this study were performed in accordance with the Declaration of Helsinki on human research participants. The authors confirmed that informed consent was obtained from all participants of this study. Consent for publication Not applicable. Availability of data and materials The data analyzed in this study are available by request from the first author. C ompeting i nterest s The authors declare that they have no competing interests. Funding This work was funded by University of Macau (CPRS-0002, MYRG-GRG2023-00087-ICMS, SRG2021-00007-ICMS, MYRG2022-00229-ICMS) Authors' contributors GHL: study concept and design, data collection, data analysis, and drafting of the manuscript. DHC: data collection. HH: a critical review of the manuscript. COLU: study concept and design, data collection and a critical review of the manuscript. Acknowledgments The authors acknowledge the help from pediatrician of The First Affiliated Hospital of Guangzhou Medical University. References Global Initiative for Asthma. Global Strategy for Asthma Management and Prevention. 2022. https://ginasthma.org/wp-content/uploads/2022/07/GINA-Main-Report-2022-FINAL-22-07-01-WMS.pdf . Accessed December 1, 2023. García-Marcos L, Asher MI, Pearce N, et al. The burden of asthma, hay fever and eczema in children in 25 countries: GAN Phase I study. 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Community pharmacists' opinions and practice of pharmaceutical care at chain pharmacy and independent pharmacy in China. Int J Clin Pharm. 2019;41(2):478–87. Chen H, Ung COL, Chi P, Wu J, Tang D, Hu H. Consumers' Perceptions About Pharmaceutical Care Provided by Community Pharmacists in China in Relation to Over-the-Counter Drugs: A Qualitative Study. Inquiry. 2018;55:46958018793292. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Published Journal Publication published 02 Aug, 2025 Read the published version in BMC Primary Care → Version 1 posted Editorial decision: Revision requested 20 Jun, 2024 Editor assigned by journal 17 Jun, 2024 Submission checks completed at journal 17 Jun, 2024 First submitted to journal 14 Jun, 2024 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4581375","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":316792287,"identity":"9c3d45f8-7e7a-41b8-92f3-40112cf32808","order_by":0,"name":"Guohua Lin","email":"","orcid":"","institution":"University of Macau","correspondingAuthor":false,"prefix":"","firstName":"Guohua","middleName":"","lastName":"Lin","suffix":""},{"id":316792289,"identity":"c2788a54-38b7-48a8-b4bd-5f6919ecb764","order_by":1,"name":"Dehui Chen","email":"","orcid":"","institution":"The First Affiliated Hospital of Guangzhou Medical University","correspondingAuthor":false,"prefix":"","firstName":"Dehui","middleName":"","lastName":"Chen","suffix":""},{"id":316792290,"identity":"02661ee6-fb90-49c8-bdb1-8313b0a8e0d4","order_by":2,"name":"Hao Hu","email":"","orcid":"","institution":"University of Macau","correspondingAuthor":false,"prefix":"","firstName":"Hao","middleName":"","lastName":"Hu","suffix":""},{"id":316792292,"identity":"3c8fc031-35b9-428f-89dd-6a1304023c18","order_by":3,"name":"Carolina Oi Lam Ung","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA4UlEQVRIiWNgGAWjYLCCBwZgivEBmDpAjJYEiBZmAxK0QCg2CaK08LefffggoeCOvMHt9mvVvDkMcnw3Elg3fMCjReJMurFBgsEzww13zpTd5t3GYCx5I4Ht5gw8WgwY0tgkEgwOM264kZMG0pK4AajlNg8+LfzPwFrsQVqKgVrqCWuRgNgCNDz9GDNQS4IBIS0SN54xA/1yOHnmjRxmybnbJAxnnnnYhtcv/P1pjA8+/Dls23cj/eGHt9ts5PmOJx+7gS/EkAAPKCZBUcPYQJwGBgb2B8SqHAWjYBSMghEGABZeUqLUpQvDAAAAAElFTkSuQmCC","orcid":"","institution":"University of Macau","correspondingAuthor":true,"prefix":"","firstName":"Carolina","middleName":"Oi Lam","lastName":"Ung","suffix":""}],"badges":[],"createdAt":"2024-06-14 10:26:52","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4581375/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4581375/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s12875-025-02936-5","type":"published","date":"2025-08-02T16:21:41+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":60353650,"identity":"32450df6-dec4-4f8a-81ca-42b6eef6b375","added_by":"auto","created_at":"2024-07-15 23:42:19","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":80935,"visible":true,"origin":"","legend":"\u003cp\u003ePerception of non-pharmacological interventions by family caregivers of pediatric patients with asthma\u003c/p\u003e","description":"","filename":"Figure1.Perceptionofnonpharmacologicalinterventionsbyfamilycaregiversofpediatricpatientswithasthma.png","url":"https://assets-eu.researchsquare.com/files/rs-4581375/v1/791caae6502b6f590653d74c.png"},{"id":60353952,"identity":"55ebfea1-954a-4e73-8628-5e2cdb31c16a","added_by":"auto","created_at":"2024-07-15 23:50:19","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":88930,"visible":true,"origin":"","legend":"\u003cp\u003ePerception of disease management by family caregivers of pediatric patients with asthma\u003c/p\u003e","description":"","filename":"Figure2.Perceptionofdiseasemanagementbyfamilycaregiversofpediatricpatientswithasthma.png","url":"https://assets-eu.researchsquare.com/files/rs-4581375/v1/07a3a443492cf8e04ce7da9a.png"},{"id":60353645,"identity":"cb74f107-a8ba-471e-8a68-68132335383d","added_by":"auto","created_at":"2024-07-15 23:42:19","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":116180,"visible":true,"origin":"","legend":"\u003cp\u003ePerception of medication use by family caregivers of pediatric patients with asthma\u003c/p\u003e","description":"","filename":"Figure3.Perceptionofmedicationusebyfamilycaregiversofpediatricpatientswithasthma.png","url":"https://assets-eu.researchsquare.com/files/rs-4581375/v1/a5cb07647a56d85b0509426a.png"},{"id":60353953,"identity":"380ce331-3369-4b8b-a622-028e508e4d6b","added_by":"auto","created_at":"2024-07-15 23:50:19","extension":"png","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":75906,"visible":true,"origin":"","legend":"\u003cp\u003ePerception of disease knowledge by family caregivers of pediatric patients with asthma\u003c/p\u003e","description":"","filename":"Figure4.Perceptionofdiseaseknowledgebyfamilycaregiversofpediatricpatientswithasthma.png","url":"https://assets-eu.researchsquare.com/files/rs-4581375/v1/3f6a1782d3605385bea9c727.png"},{"id":60355518,"identity":"561ed003-1aaa-4431-b6ef-df261817e395","added_by":"auto","created_at":"2024-07-16 00:06:19","extension":"png","order_by":5,"title":"Figure 5","display":"","copyAsset":false,"role":"figure","size":93774,"visible":true,"origin":"","legend":"\u003cp\u003eBurden of family caregivers due to pediatric asthma\u003c/p\u003e","description":"","filename":"Figure5.Burdenoffamilycaregiversduetopediatricasthma.png","url":"https://assets-eu.researchsquare.com/files/rs-4581375/v1/382a41a2461c11dca5bacc33.png"},{"id":60355031,"identity":"319664e9-173a-44cb-955b-387725554ac4","added_by":"auto","created_at":"2024-07-15 23:58:19","extension":"png","order_by":6,"title":"Figure 6","display":"","copyAsset":false,"role":"figure","size":205321,"visible":true,"origin":"","legend":"\u003cp\u003eNeeds of pharmaceutical care by family caregivers of pediatric patients with asthma\u003c/p\u003e","description":"","filename":"Figure6.Needsofpharmaceuticalcarebyfamilycaregiversofpediatricpatientswithasthma.png","url":"https://assets-eu.researchsquare.com/files/rs-4581375/v1/36fdfd8121bc21cf62277e3a.png"},{"id":88268394,"identity":"96eda037-4eb7-4948-80bf-15346c73fdf9","added_by":"auto","created_at":"2025-08-04 16:51:26","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1330852,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4581375/v1/52ab62c7-a128-415a-81e5-ee8c32747676.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Exploring the perception and the needs of pharmaceutical care perceived by family caregivers of pediatric asthma patients in Guangdong Province, China: a cross-sectional survey study","fulltext":[{"header":"Background","content":"\u003cp\u003eAsthma is a heterogeneous disease usually characterized by chronic airway inflammation. The symptoms include wheeze, shortness of breath, chest tightness, and cough\u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u003c/sup\u003e. Asthma is one of the most common chronic diseases in childhood, affecting approximately 10% of children worldwide\u003csup\u003e\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u003c/sup\u003e. The Global Burden of Disease Study (GBD) estimated that in 2019, asthma caused 21.6\u0026nbsp;million disability adjusted life years (DALYs) across all ages globally and was ranked 34th among the causes of burden of disease\u003csup\u003e\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u003c/sup\u003e. A retrospective study showed that in China, the annual cost of mild, moderate, and severe pediatric asthma patients aged 6 to 14 were CNY 1,094, CNY 1,660 and CNY 3,020 respectively, placing a heavy economic burden on the healthcare system.\u003csup\u003e\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eBetween 1990 and 2020, the prevalence of pediatric asthma in China has increased in both sexes\u003csup\u003e\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e\u003c/sup\u003e. A study conducted in 30 cities in China showed that according to the asthma control level classification defined by Global Initiative for Asthma (GINA), the overall control rate of asthma in urban areas of China was only 28.5%\u003csup\u003e6\u003c/sup\u003e. Another study found that asthma control was positively correlated with positive parenting style, thus healthcare professionals should encourage parents to cultivate positive parenting style\u003csup\u003e\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e\u003c/sup\u003e. For pediatric asthma management, pharmacists can improve the level of parental knowledge through patient training and counseling, thereby improving the control of pediatric asthma\u003csup\u003e\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eTo the family caregivers, caring for a child with asthma is challenging\u003csup\u003e\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e\u003c/sup\u003e. Adequate support to help them adapt and cope with the challenges is prominent. The current literature has detailed how family caregivers experienced anxiety about their children' s health, and their lack of knowledge about the disease, as well as uncertainty about management and prognosis \u003csup\u003e\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e\u003c/sup\u003e. A common conclusion drawn from the current studies suggests the need for supporting management of pediatric asthma by health professionals, particularly as healthcare becomes more patient-centered.\u003c/p\u003e \u003cp\u003eCommunity pharmacists are an integral part of the health care team in the primary care setting and are one of the most easily accessible healthcare providers\u003csup\u003e\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e\u003c/sup\u003e. In pediatric asthma management, community pharmacists can provide long-term follow-up care, including disease screening, disease knowledge education, medication adherence education, etc\u003csup\u003e\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e\u003c/sup\u003e. The advantage of community pharmacists is that they are distributed around the patient's living area, able to fully interact with patients. Many studies have demonstrated that pharmacist interventions can benefit pediatric asthma patients in improving asthma control, pulmonary function, medication adherence, inhaler technique, quality of life, etc\u003csup\u003e\u003cspan additionalcitationids=\"CR15 CR16 CR17 CR18\" citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eDespite the emerging studies focusing on pharmaceutical services for pediatric asthma, much of the current literature focused on the interventional effects. There is still a lack of research on the pharmaceutical care needs of pediatric asthma patients/caregivers. Considering the enormous burden of pediatric asthma in China, this study aims to explore the level of understanding of asthma among family caregivers, the burden they faced in caring for children with asthma, and their needs of pharmaceutical care in Guangdong Province, China.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStudy Design and Participants\u003c/h2\u003e \u003cp\u003eThis was a cross-sectional survey-based study. Family caregivers of pediatric asthma patients living in Guangdong Province were eligible for inclusion in the study. The data was collected from January to April 2024 using convenience sampling. The valid sample size for this study was determined at a minimum of 384 (confidence level 95%, margin of error 5%). An invitation to complete the online survey in this study was extended to the caregivers through the outpatient clinic in a tertiary hospital, social media and patient/caregiver chatgroups. All information was collected anonymously. The first page of the questionnaire included the participation information statement, followed by the agree/disagree options at the end of the page. Those who agreed to participate in the study navigated to the questionnaire when they clicked the agree button.\u003c/p\u003e \u003cp\u003eQuestionnaire design\u003c/p\u003e \u003cp\u003eThe design of the questionnaire was based on a previous literature review on pharmacist intervention for pediatric asthma\u003csup\u003e\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e\u003c/sup\u003e. The questionnaire consisted of 5 sections, including participant qualification confirmation (1 question), demographics (9 questions), caregivers\u0026rsquo; perception of asthma-related knowledge (19 questions), the burden on caregivers due to pediatric asthma (5 questions), and their needs of pharmaceutical care provided by community pharmacists (12 questions). Participants could review and change their answers at any time through the \"Previous\" button. Prior to the official distribution of the survey questionnaire, a pilot study was conducted to solicit opinions on the appropriateness of the content and wording of the questions. To this end, 26 family caregivers were recruited. They read the entire questionnaire and raised any doubts about the questions asked. All items in the survey were retained, but some question expressions were modified to facilitate understanding. The reliability and validity test results showed that, Cronbach\u0026rsquo;s alpha was acceptable for those subscales (Cronbach's α\u0026thinsp;\u0026gt;\u0026thinsp;0.5), and the Kaiser-Meyer-Olkin value of 0.875 indicated a highly acceptable score with a significant Bartlett's test of sphericity (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05).\u003c/p\u003e \u003c/div\u003e\n\u003cp\u003eEthical approval\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe study was reviewed and approved by the University of Macau research committee from the school of Institute of Chinese Medical Sciences (Ethics Assessment ID: SSHRE23-APP071-ICMS). Consent and confirmation were obtained at the beginning of the questionnaire.\u003c/p\u003e\n\u003cp\u003eStatistical analysis\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eExcel and IBM SPSS version 24.0\u0026nbsp;were used for data analysis. Descriptive statistics were use to describe the demographic characteristics,\u0026nbsp;caregivers\u0026rsquo; perception of asthma-related knowledge, the burden on caregivers\u0026nbsp;due to pediatric\u0026nbsp;asthma, and needs of pharmaceutical services provided by community pharmacists.\u0026nbsp;Frequencies and percentages were calculated for demographic data.\u0026nbsp;For the\u0026nbsp;perception of asthma-related knowledge\u0026nbsp;data, the maximum score was\u0026nbsp;95\u0026nbsp;points. The respondents were assigned to three groups: low knowledge, 0-28 points (\u0026lt;30%); moderate knowledge, 29-66 points (30%-70%); high knowledge, 67-95 points (\u0026gt;70%). For the\u0026nbsp;burden on caregivers due to pediatric asthma\u0026nbsp;data,\u0026nbsp;the maximum score was\u0026nbsp;25\u0026nbsp;points. The respondents were assigned to three groups: low burden, 0-7 points (\u0026lt;30%); moderate burden, 8-17 points (30%-70%); high burden, 18-25 points (\u0026gt;70%). For the\u0026nbsp;needs of pharmaceutical\u0026nbsp;care\u0026nbsp;provided by community pharmacists\u0026nbsp;data,\u0026nbsp;the maximum score was\u0026nbsp;60\u0026nbsp;points. The respondents were assigned to three groups: low level of needs, 0-17 points (\u0026lt;30%); moderate level of needs, 18-42 points (30%-70%); high level of needs, 43-60 points (\u0026gt;70%). The range was based on the literature recommendations\u003csup\u003e21\u003c/sup\u003e.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe Kolmogorov\u0026ndash;Smirnov test was performed to test data normality. Univariate analyses were performed using the Mann\u0026ndash;Whitney U or Kruskal\u0026ndash;Wallis test for continuous variables with non-normal distribution. Correlation analyses were performed using Spearman\u0026rsquo;s correlation coefficient. A generalized linear regression model was developed to understand which factors were associated with pharmaceutical care needs by family caregivers of pediatric asthma patients due to non-normally distributed data. Statistical significance was considered for \u003cem\u003ep\u003c/em\u003e-values \u0026lt;0.05.\u0026nbsp;\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003e\u003cem\u003eDemographic Characteristics\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eA total of 787 family caregivers participated accessed this online survey, of whom 610 completed it, given a completion rate of 77.5%.\u0026nbsp;As shown in\u0026nbsp;Table\u0026nbsp;1,\u0026nbsp;60% of the participants were women.\u0026nbsp;The vast majority of the participants aged between 35 and 44 years (48%). Almost all questionnaires were completed by the parents of pediatric asthma patients (99.3%). More than 98% of participants were taking care of one pediatric asthma patient. Approximately 14% of participants had been caring for pediatric asthma patient(s) for less than 6 months, while around 41% of participants more than 2 years. Among children with asthma taken care of by participating family caregivers, the proportion of asthma patients aged 3 to 9 was the highest, accounting for 51.2%. The proportion of boys (60%) was higher than that of girls (40%). Most pediatric asthma patients experienced intermittent(51.5%)\u0026nbsp;or mild persistent (36.1%) asthma severity.\u003c/p\u003e\n\u003cp\u003eTable 1.\u0026nbsp;Demographics\u0026nbsp;characteristics of participants (n=610)\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"552\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"39.130434782608695%\"\u003e\n \u003cp\u003e\u003cstrong\u003eDemographic characteristics\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.434782608695652%\"\u003e\n \u003cp\u003e\u003cstrong\u003eCases\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.434782608695652%\"\u003e\n \u003cp\u003e\u003cstrong\u003e%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"39.130434782608695%\" valign=\"top\"\u003e\n \u003cp\u003eGender\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.434782608695652%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.434782608695652%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"39.130434782608695%\" valign=\"top\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.434782608695652%\" valign=\"top\"\u003e\n \u003cp\u003e366\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.434782608695652%\" valign=\"top\"\u003e\n \u003cp\u003e60.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"39.130434782608695%\" valign=\"top\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.434782608695652%\" valign=\"top\"\u003e\n \u003cp\u003e244\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.434782608695652%\" valign=\"top\"\u003e\n \u003cp\u003e40.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"39.130434782608695%\" valign=\"top\"\u003e\n \u003cp\u003eAge (years)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.434782608695652%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.434782608695652%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"39.130434782608695%\" valign=\"top\"\u003e\n \u003cp\u003e25-34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.434782608695652%\" valign=\"top\"\u003e\n \u003cp\u003e280\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.434782608695652%\" valign=\"top\"\u003e\n \u003cp\u003e45.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"39.130434782608695%\" valign=\"top\"\u003e\n \u003cp\u003e35-44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.434782608695652%\" valign=\"top\"\u003e\n \u003cp\u003e293\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.434782608695652%\" valign=\"top\"\u003e\n \u003cp\u003e48.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"39.130434782608695%\" valign=\"top\"\u003e\n \u003cp\u003e45-54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.434782608695652%\" valign=\"top\"\u003e\n \u003cp\u003e36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.434782608695652%\" valign=\"top\"\u003e\n \u003cp\u003e5.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"39.130434782608695%\" valign=\"top\"\u003e\n \u003cp\u003e54+\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.434782608695652%\" valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.434782608695652%\" valign=\"top\"\u003e\n \u003cp\u003e0.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"39.130434782608695%\" valign=\"top\"\u003e\n \u003cp\u003eRelationship with pediatric asthma patients\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.434782608695652%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.434782608695652%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"39.130434782608695%\" valign=\"top\"\u003e\n \u003cp\u003eParents\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.434782608695652%\" valign=\"top\"\u003e\n \u003cp\u003e606\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.434782608695652%\" valign=\"top\"\u003e\n \u003cp\u003e99.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"39.130434782608695%\" valign=\"top\"\u003e\n \u003cp\u003eGrandparents\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.434782608695652%\" valign=\"top\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.434782608695652%\" valign=\"top\"\u003e\n \u003cp\u003e0.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"39.130434782608695%\" valign=\"top\"\u003e\n \u003cp\u003eNumber of pediatric asthma patients taking care of\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.434782608695652%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.434782608695652%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"39.130434782608695%\" valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.434782608695652%\" valign=\"top\"\u003e\n \u003cp\u003e602\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.434782608695652%\" valign=\"top\"\u003e\n \u003cp\u003e98.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"39.130434782608695%\" valign=\"top\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.434782608695652%\" valign=\"top\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.434782608695652%\" valign=\"top\"\u003e\n \u003cp\u003e1.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"39.130434782608695%\" valign=\"top\"\u003e\n \u003cp\u003eDuration of taking care of pediatric asthma patients\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.434782608695652%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.434782608695652%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"39.130434782608695%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026lt; 6 months\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.434782608695652%\" valign=\"top\"\u003e\n \u003cp\u003e84\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.434782608695652%\" valign=\"top\"\u003e\n \u003cp\u003e13.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"39.130434782608695%\" valign=\"top\"\u003e\n \u003cp\u003e6-12 months\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.434782608695652%\" valign=\"top\"\u003e\n \u003cp\u003e99\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.434782608695652%\" valign=\"top\"\u003e\n \u003cp\u003e16.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"39.130434782608695%\" valign=\"top\"\u003e\n \u003cp\u003e1-2 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.434782608695652%\" valign=\"top\"\u003e\n \u003cp\u003e177\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.434782608695652%\" valign=\"top\"\u003e\n \u003cp\u003e29.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"39.130434782608695%\" valign=\"top\"\u003e\n \u003cp\u003e3 years or above\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.434782608695652%\" valign=\"top\"\u003e\n \u003cp\u003e250\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.434782608695652%\" valign=\"top\"\u003e\n \u003cp\u003e41.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"39.130434782608695%\" valign=\"top\"\u003e\n \u003cp\u003eAge of your pediatric asthma patients (years)\u003csup\u003e\u0026nbsp;#\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.434782608695652%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.434782608695652%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"39.130434782608695%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026lt;3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.434782608695652%\" valign=\"top\"\u003e\n \u003cp\u003e48\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.434782608695652%\" valign=\"top\"\u003e\n \u003cp\u003e7.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"39.130434782608695%\" valign=\"top\"\u003e\n \u003cp\u003e3-6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.434782608695652%\" valign=\"top\"\u003e\n \u003cp\u003e161\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.434782608695652%\" valign=\"top\"\u003e\n \u003cp\u003e26.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"39.130434782608695%\" valign=\"top\"\u003e\n \u003cp\u003e7-9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.434782608695652%\" valign=\"top\"\u003e\n \u003cp\u003e155\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.434782608695652%\" valign=\"top\"\u003e\n \u003cp\u003e25.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"39.130434782608695%\" valign=\"top\"\u003e\n \u003cp\u003e10-12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.434782608695652%\" valign=\"top\"\u003e\n \u003cp\u003e138\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.434782608695652%\" valign=\"top\"\u003e\n \u003cp\u003e22.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"39.130434782608695%\" valign=\"top\"\u003e\n \u003cp\u003e13- \u0026lt;18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.434782608695652%\" valign=\"top\"\u003e\n \u003cp\u003e116\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.434782608695652%\" valign=\"top\"\u003e\n \u003cp\u003e18.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"39.130434782608695%\" valign=\"top\"\u003e\n \u003cp\u003eGender of your pediatric asthma patients\u003csup\u003e#\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.434782608695652%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.434782608695652%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"39.130434782608695%\" valign=\"top\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.434782608695652%\" valign=\"top\"\u003e\n \u003cp\u003e247\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.434782608695652%\" valign=\"top\"\u003e\n \u003cp\u003e40.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"39.130434782608695%\" valign=\"top\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.434782608695652%\" valign=\"top\"\u003e\n \u003cp\u003e371\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.434782608695652%\" valign=\"top\"\u003e\n \u003cp\u003e60.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"39.130434782608695%\" valign=\"top\"\u003e\n \u003cp\u003eSeverity of asthma experienced by\u0026nbsp;the child(ren)\u0026nbsp;in the past 6 months\u003csup\u003e#\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.434782608695652%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.434782608695652%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"39.130434782608695%\" valign=\"top\"\u003e\n \u003cp\u003eIntermittent state*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.434782608695652%\" valign=\"top\"\u003e\n \u003cp\u003e318\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.434782608695652%\" valign=\"top\"\u003e\n \u003cp\u003e51.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"39.130434782608695%\" valign=\"top\"\u003e\n \u003cp\u003eMild persistent**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.434782608695652%\" valign=\"top\"\u003e\n \u003cp\u003e223\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.434782608695652%\" valign=\"top\"\u003e\n \u003cp\u003e36.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"39.130434782608695%\" valign=\"top\"\u003e\n \u003cp\u003eModerately persistent***\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.434782608695652%\" valign=\"top\"\u003e\n \u003cp\u003e66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.434782608695652%\" valign=\"top\"\u003e\n \u003cp\u003e10.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"39.130434782608695%\" valign=\"top\"\u003e\n \u003cp\u003eSevere persistent****\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.434782608695652%\" valign=\"top\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"30.434782608695652%\" valign=\"top\"\u003e\n \u003cp\u003e1.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003csup\u003e#\u0026nbsp;\u003c/sup\u003e8 of the participants reported having to take care of 2 children with asthma so the total number of children was 618. *Intermittent state: asthma symptoms less than once a week, brief onset, nocturnal asthma symptoms less than or equal to twice a month; **Mild persistent: asthma symptoms more than or equal to once a week and less than once a day, asthma symptoms may affect activity and sleep, nocturnal asthma symptoms more than twice a month and less than once a week; ***Moderately persistent: asthma symptoms appear daily, affect activity and sleep, nocturnal asthma symptoms more than or equal to once a week; ****Severe persistent: asthma symptoms appear daily, and frequent occur, nocturnal asthma symptoms appear frequently, physical activity is limited.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003ePerception of self-reported\u003c/em\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003cem\u003easthma-related knowledge\u0026nbsp;perceived by family caregivers of pediatric asthma\u003c/em\u003e\u003cem\u003e\u0026nbsp;patients\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003ePerception of asthma-related knowledge perceived by family caregivers of pediatric patients with asthma was showed in Figures 1 to 4. Overall, 38.9% (n=237) of the participants believed that they had good asthma related knowledge, 61.0% had moderate knowledge (n=372) and 0.2% (n=1) had poor knowledge.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eNon-pharmacological interventions\u003c/em\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eIn terms of non-pharmacological interventions, caregivers believed that they had the least knowledge of peak expiratory flow meters, with only 40% of caregivers believing they knew how to use peak expiratory flow meters. In addition, caregivers were not familiar with what vaccines pediatric asthma patients should receive, with 49% of caregivers believing they had relevant knowledge about vaccination vaccine in pediatric asthma patients. Relatively, parents believed they had a greater understanding of how to ensure children\u0026rsquo;s mental health (60%) and lifestyle precautions (57%).\u003c/p\u003e\n\u003cp\u003eFigure 1. Perception of non-pharmacological interventions by family caregivers of pediatric patients with asthma\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eDisease management\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eIn terms of disease management, only 41% of caregivers believed that they had knowledge about the use of preventive drugs under seasonal changes and other reasons. Besides, 20% of caregivers believed that they did not know when to use relievers and did not know how to respond to exacerbations.\u003c/p\u003e\n\u003cp\u003eFigure 2. Perception of disease management by family caregivers of pediatric patients with asthma\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eMedication use\u003c/em\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eIn terms of medication use, caregivers believed that they had the least knowledge of the inhaler use, with only 41% of caregivers believing they knew how to use inhalers. Besides, caregivers believed that they had little understanding of the side effects and drug interactions of medications. There were 27% of caregivers who believed they had poor knowledge about side effects of medicines, and the proportion of caregivers who believed that they had poor knowledge about drug interactions reached 29%.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eFigure 3. Perception of medication use by family caregivers of pediatric patients with asthma\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eDisease knowledge\u003c/em\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eIn terms of disease knowledge, there were 21% of caregivers believed that they did not know what the risk factors of exacerbations in pediatric asthma patients were.\u003c/p\u003e\n\u003cp\u003eFigure 4. Perception of disease knowledge by family caregivers of pediatric patients with asthma\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eBurden\u0026nbsp;\u003c/em\u003e\u003cem\u003eof family caregivers\u0026nbsp;\u003c/em\u003e\u003cem\u003edue to\u0026nbsp;pediatric asthma\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe result of the\u0026nbsp;burden of family caregivers due to pediatric asthma\u0026nbsp;was shown in Figure\u0026nbsp;5.\u0026nbsp;Overall, 59.2% (n=361) of the participants believed that they bore a high burden, 40.5% bore a moderate burden (n=247) and 0.3% (n=2) bore a low burden. Especially with the greatest psychological burden, 70% of caregivers expressed concern about their children suffering from asthma. In addition, 59% of caregivers reported that their child/children\u0026apos;s asthma had a negative impact on their quality of life. More than 60% of caregivers indicated that they needed more support from healthcare professionals.\u003c/p\u003e\n\u003cp\u003eFigure 5. Burden of family caregivers due to pediatric asthma\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eNeeds of\u0026nbsp;\u003c/em\u003e\u003cem\u003epharmaceutical care by family caregivers of pediatric patients with asthma\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe results on the needs of pharmaceutical care by family caregivers of pediatric patients with asthma were shown in Figure 6. Overall, 54.9% (n=335) of the participants had a high level of need for pharmaceutical care and 45.1% (n=275) had a moderate level of need. For pharmaceutical care provided by community pharmacists, \u0026nbsp;caregivers had the highest demand for asthma disease education and the lowest demand for psychological counseling and suggestion on asthma therapeutic regimens.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eFigure 6. Needs of pharmaceutical care by family caregivers of pediatric patients with asthma\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eFactors associated with pharmaceutical care needs\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eUnivariate analyses were conducted to determine the association of participants\u0026rsquo; gender, age, durations of taking care of pediatric asthma patients and the severities of asthma experienced by the child(ren) in the past 6 months with the mean score of pharmaceutical care needs by family caregivers of pediatric asthma patients, respectively. The results revealed significant differences in the mean score of pharmaceutical care needs by family caregivers of pediatric asthma patients of different genders, durations of taking care of pediatric asthma patients and severities of asthma experienced by the child(ren) in the past 6 months (\u003cem\u003ep\u0026nbsp;\u003c/em\u003e\u0026lt; 0.05). Correlation analyses revealed there was a significant correlation between\u0026nbsp;the\u0026nbsp;mean score of\u0026nbsp;burden of family caregivers due to pediatric asthma\u0026nbsp;and the\u0026nbsp;mean score of pharmaceutical care needs by family caregivers of pediatric asthma patients (\u003cem\u003ep\u0026nbsp;\u003c/em\u003e\u0026lt; 0.05). Generalized multiple linear regression was presented in Table 2, which showed the dependent variable pharmaceutical care needs demonstrated significant associations with the independent variables: male (B = -0.145, \u003cem\u003ep\u003c/em\u003e = 0.001), age (B = 0.014,\u003cem\u003e\u0026nbsp;p\u003c/em\u003e = 0.001), duration of taking care of pediatric asthma patients less than 6 months (B = 0.215, \u003cem\u003ep\u003c/em\u003e = 0.004), and the mean score of burden (B = 0.332, \u003cem\u003ep\u003c/em\u003e = 0.000).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTable 2. Generalized\u0026nbsp;multiple\u0026nbsp;linear regression\u0026nbsp;analysis between various factors and mean score of needs of pharmaceutical care by family caregivers of pediatric patients with asthma\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"553\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.922242314647377%\" rowspan=\"2\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariables\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.06148282097649%\" rowspan=\"2\"\u003e\n \u003cp\u003e\u003cstrong\u003eB\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"34.177215189873415%\" colspan=\"2\"\u003e\n \u003cp\u003e\u003cstrong\u003e95%CI\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.839059674502712%\" rowspan=\"2\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003ep\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"44.973544973544975%\"\u003e\n \u003cp\u003e\u003cstrong\u003eLower\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"55.026455026455025%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eUpper\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.922242314647377%\" valign=\"top\"\u003e\n \u003cp\u003eGender\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.06148282097649%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.370705244122966%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.806509945750452%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.839059674502712%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.922242314647377%\" valign=\"top\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.06148282097649%\" valign=\"top\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.370705244122966%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.806509945750452%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.839059674502712%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.922242314647377%\" valign=\"top\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.06148282097649%\" valign=\"top\"\u003e\n \u003cp\u003e-0.145\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.370705244122966%\" valign=\"top\"\u003e\n \u003cp\u003e-.230\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.806509945750452%\" valign=\"top\"\u003e\n \u003cp\u003e-.061\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.839059674502712%\" valign=\"top\"\u003e\n \u003cp\u003e0.001*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.922242314647377%\" valign=\"top\"\u003e\n \u003cp\u003eAge (years)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.06148282097649%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.370705244122966%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.806509945750452%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.839059674502712%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.922242314647377%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.06148282097649%\" valign=\"top\"\u003e\n \u003cp\u003e0.014\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.370705244122966%\" valign=\"top\"\u003e\n \u003cp\u003e0.006\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.806509945750452%\" valign=\"top\"\u003e\n \u003cp\u003e0.023\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.839059674502712%\" valign=\"top\"\u003e\n \u003cp\u003e0.001*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.922242314647377%\" valign=\"top\"\u003e\n \u003cp\u003eDuration of taking care of pediatric asthma patients\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.06148282097649%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.370705244122966%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.806509945750452%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.839059674502712%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.922242314647377%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026lt; 6 months\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.06148282097649%\" valign=\"top\"\u003e\n \u003cp\u003e0.215\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.370705244122966%\" valign=\"top\"\u003e\n \u003cp\u003e0.071\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.806509945750452%\" valign=\"top\"\u003e\n \u003cp\u003e0.360\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.839059674502712%\" valign=\"top\"\u003e\n \u003cp\u003e0.004*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.922242314647377%\" valign=\"top\"\u003e\n \u003cp\u003e6-12 months\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.06148282097649%\" valign=\"top\"\u003e\n \u003cp\u003e0.109\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.370705244122966%\" valign=\"top\"\u003e\n \u003cp\u003e-0.021\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.806509945750452%\" valign=\"top\"\u003e\n \u003cp\u003e0.238\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.839059674502712%\" valign=\"top\"\u003e\n \u003cp\u003e0.100\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.922242314647377%\" valign=\"top\"\u003e\n \u003cp\u003e1-2 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.06148282097649%\" valign=\"top\"\u003e\n \u003cp\u003e0.039\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.370705244122966%\" valign=\"top\"\u003e\n \u003cp\u003e-0.070\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.806509945750452%\" valign=\"top\"\u003e\n \u003cp\u003e0.147\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.839059674502712%\" valign=\"top\"\u003e\n \u003cp\u003e0.483\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.922242314647377%\" valign=\"top\"\u003e\n \u003cp\u003e3 years or above\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.06148282097649%\" valign=\"top\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.370705244122966%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.806509945750452%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.839059674502712%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.922242314647377%\" valign=\"top\"\u003e\n \u003cp\u003eSeverity of asthma experienced by\u0026nbsp;the child(ren)\u0026nbsp;in the past 6 months\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.06148282097649%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.370705244122966%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.806509945750452%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.839059674502712%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.922242314647377%\" valign=\"top\"\u003e\n \u003cp\u003eIntermittent state\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.06148282097649%\" valign=\"top\"\u003e\n \u003cp\u003e0.157\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.370705244122966%\" valign=\"top\"\u003e\n \u003cp\u003e-0.159\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.806509945750452%\" valign=\"top\"\u003e\n \u003cp\u003e0.473\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.839059674502712%\" valign=\"top\"\u003e\n \u003cp\u003e0.331\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.922242314647377%\" valign=\"top\"\u003e\n \u003cp\u003eMild persistent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.06148282097649%\" valign=\"top\"\u003e\n \u003cp\u003e-0.056\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.370705244122966%\" valign=\"top\"\u003e\n \u003cp\u003e-0.371\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.806509945750452%\" valign=\"top\"\u003e\n \u003cp\u003e0.258\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.839059674502712%\" valign=\"top\"\u003e\n \u003cp\u003e0.725\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.922242314647377%\" valign=\"top\"\u003e\n \u003cp\u003eModerately persistent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.06148282097649%\" valign=\"top\"\u003e\n \u003cp\u003e-0.052\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.370705244122966%\" valign=\"top\"\u003e\n \u003cp\u003e-0.378\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.806509945750452%\" valign=\"top\"\u003e\n \u003cp\u003e0.274\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.839059674502712%\" valign=\"top\"\u003e\n \u003cp\u003e0.754\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.922242314647377%\" valign=\"top\"\u003e\n \u003cp\u003eSevere persistent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.06148282097649%\" valign=\"top\"\u003e\n \u003cp\u003eRef\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.370705244122966%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.806509945750452%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.839059674502712%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"30.922242314647377%\" valign=\"top\"\u003e\n \u003cp\u003eAverage\u0026nbsp;score of\u0026nbsp;burden\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.06148282097649%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 0 \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;.332\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.370705244122966%\" valign=\"top\"\u003e\n \u003cp\u003e.263\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.806509945750452%\" valign=\"top\"\u003e\n \u003cp\u003e.402\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.839059674502712%\" valign=\"top\"\u003e\n \u003cp\u003e.000*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e*: \u003cem\u003ep\u003c/em\u003e \u0026lt;0.05\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis study is one of the very few studies that investigated the challenges and burden faced by family caregivers of pediatric asthma patients, and their needs of pharmaceutical care provided by community pharmacists. The survey results showed an insufficient asthma-related knowledge perceived by family caregivers of pediatric patients with asthma (38.9%), a high burden of family caregivers due to pediatric asthma (59.2%), and a high level of need for pharmaceutical care provided by community pharmacists (54.9%). In addition, a positive association was identified between female, older age, duration of taking care of pediatric asthma patients less than 6 months, and higher burden with the needs of pharmaceutical care needs by family caregivers of pediatric asthma patients. Overall, these findings revealed the necessity of further leveraging the role of community pharmacists to support family caregivers in better caring for children with asthma and helped inform the potential contributions of community pharmaceutical care to pediatric asthma management.\u003c/p\u003e\n\u003cp\u003eThe findings that family caregivers considered they lacked sufficient understanding of asthma related knowledge is consistent with other recent similar studies. A study in Jeddah found that parents had myths about asthma and the proportion of parents with correct understanding of various asthma knowledge ranged from 56.0% to 88.7%\u003csup\u003e22\u003c/sup\u003e. Similarly, a study in Saudi Arabia also found the total knowledge score for the caregivers ranged from 43 to 64 (total score: 85)\u003csup\u003e11\u003c/sup\u003e. Related studies also reported that only 32% of the caregivers of asthmatic children had adequate knowledge of asthma in Indian\u003csup\u003e23\u003c/sup\u003e. This study reiterated that family caregivers of asthmatic children had insufficient knowledge about asthma in China.\u003c/p\u003e\n\u003cp\u003eA noteworthy finding is that family caregivers had the least understanding about the use of preventive drugs under seasonal changes and other reasons (41%), which was very unfavorable for the prevention of acute attacks in pediatric asthma management. Besides, the proportion of caregivers who understood the risk factors of exacerbations was also relatively low (50%). Asthma attacks often require hospitalization for treatment, which brings significant burden to patients and families\u003csup\u003e24\u003c/sup\u003e. While developing treatment methods for acute exacerbation\u003csup\u003e25\u003c/sup\u003e, it is also crucial to promptly identify children with asthma at risk of exacerbation, as proactive measures can be taken to prevent these attacks\u003csup\u003e26\u003c/sup\u003e. A multicenter clinical trial study showed that preseason treatment could reduce autumn asthma attacks\u003csup\u003e27\u003c/sup\u003e, which is an important reminder that community pharmacists could provide to the caregivers of the pediatric asthma patients.\u003c/p\u003e\n\u003cp\u003eIt is a common consensus that pediatric asthma imposes a significant burden on caregivers. An integrative review of 80 studies indicated that family caregivers of pediatric asthma patients faced significant psychological burden, including decreased mental health, quality of life, sleep, family stress, etc. and socioeconomic burden, including poor access to care, work and financial challenges\u003csup\u003e10\u003c/sup\u003e. Given that asthma is a chronic disease that requires long-term monitoring and management, family caregivers need to spend substantial effort taking care of their children, especially paying attention to acute asthma attacks caused by seasons, allergens, and other factors\u003csup\u003e28\u003c/sup\u003e. This brings a significant psychological burden to family caregivers. A study showed that getting more support from pharmaceutical care provided by pharmacists is beneficial for controlling childhood asthma and reducing the economic burden on family caregivers\u003csup\u003e16\u003c/sup\u003e.\u003c/p\u003e\n\u003cp\u003eTo our knowledge, there are currently few studies exploring the needs for pharmaceutical care from the perspective of caregivers/pediatric asthma patients. A comprehensive understanding of the unmet needs of family caregivers/pediatric asthma patients is necessary to develop a community pharmacist led pharmaceutical care plan for children with asthma. The findings of this study indicated that family caregivers had a high level of need for community pharmacists to provide disease education, dispense asthma medications, guide the use of inhaled medications, and emphasize the importance of adherence to asthma treatment. Existing studies research suggested that community pharmacist interventions could improve patients\u0026rsquo; asthma knowledge, inhaler technique, and medication adherence\u003csup\u003e14-17\u003c/sup\u003e.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe results of this study showed that pharmaceutical care needs by family caregivers of pediatric asthma patients were independently correlated with gender, age, duration of taking care of pediatric asthma patients, and average burden. Family caregivers with insufficient understanding of asthma related knowledge will undoubtedly require related information from healthcare professionals such as community pharmacists\u003csup\u003e29\u003c/sup\u003e. For caregivers who take care of pediatric asthma patients for less than one year or have insufficient understanding of asthma, they need more attention and pharmaceutical care provided by community pharmacists\u003csup\u003e19\u003c/sup\u003e.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eA survey in China showed that community pharmacists\u0026rsquo; practice in pharmaceutical care needs improvement\u003csup\u003e30\u003c/sup\u003e. On the one hand, community pharmacists need to improve their understanding and practice of pharmaceutical care\u003csup\u003e30\u003c/sup\u003e. On the other hand, the results of a qualitative study in China revealed that consumers\u0026apos; previous experiences in community pharmacies were far from satisfactory, leading to a general lack of trust in the certification and qualifications, knowledge, communication skills, and attitude of community pharmacists\u003csup\u003e31\u003c/sup\u003e. This study indicated that family caregivers of pediatric asthma patients had a significant demand for pharmaceutical care of community pharmacists. Therefore, in the future, it is necessary to enhance the knowledge of community pharmacists about chronic diseases such as asthma through training and other methods and thus better provide pharmaceutical services for pediatric asthma patients.\u003c/p\u003e\n\u003cp\u003eHowever, it is worth noting that this study also has certain limitations. This study only collected questionnaires in Guangdong Province. Future studies should draw nationally representative population sample. In addition, family caregivers were free to participate and complete the questionnaire. Therefore, it cannot be ruled out that this self-selected sample may inevitably generate sampling bias. Moreover, the caregiver\u0026apos;s understanding of asthma related knowledge analyzed in this study was based on the responses to the questionnaires, and there may be recall bias. In order to gain a more objective understanding of caregiver\u0026apos;s asthma knowledge, observational studies can be conducted in the future.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003ePediatric asthma brings a significant burden to families, and many caregivers may not have sufficient understanding of asthma. More attention should be paid to caregiver\u0026rsquo;s needs for pharmaceutical care and try to meet their needs. In the future, it is necessary to fully leverage the role of community pharmacists and improve China\u0026apos;s primary healthcare system to meet the pharmaceutical care needs of caregivers for pediatric asthma patients and provide better management for pediatric asthma patients.\u003c/p\u003e"},{"header":"List Of Abbreviations","content":"\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"No\" id=\"Taba\" border=\"1\"\u003e \u003ccolgroup cols=\"2\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eGBD\u003c/div\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003eGlobal Burden of Disease\u003c/div\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eDALYs\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003eDisability adjusted life years\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cdiv class=\"SimplePara\"\u003eGINA\u003c/div\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cdiv class=\"SimplePara\"\u003eGlobal Initiative for Asthma\u003c/div\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e "},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u0026nbsp;\u003c/strong\u003eThe study was approved by the University of Macau research committee from the school of Institute of Chinese Medical Sciences (Ethics Assessment ID: SSHRE23-APP071-ICMS).\u003c/p\u003e\n\u003cp\u003eAll methods in this study were performed in accordance with the Declaration of Helsinki on human research participants.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe authors confirmed that informed consent was obtained from all participants of this study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u0026nbsp;\u003c/strong\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u0026nbsp;\u003c/strong\u003eThe data analyzed in this study are available by request from the first author.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eC\u003c/strong\u003e\u003cstrong\u003eompeting\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003ei\u003c/strong\u003e\u003cstrong\u003enterest\u003c/strong\u003e\u003cstrong\u003es\u0026nbsp;\u003c/strong\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003eThis work was funded by University of Macau (CPRS-0002, MYRG-GRG2023-00087-ICMS, SRG2021-00007-ICMS, MYRG2022-00229-ICMS)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026apos; contributors\u003c/strong\u003e\u0026nbsp;GHL: study concept and design, data collection, data analysis, and drafting of the manuscript. DHC: data collection. HH: a critical review of the manuscript. COLU: study concept and design, data collection and a critical review of the manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgments\u003c/strong\u003e The authors acknowledge the help from pediatrician of The First Affiliated Hospital of Guangzhou Medical University. \u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eGlobal Initiative for Asthma. Global Strategy for Asthma Management and Prevention. 2022. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://ginasthma.org/wp-content/uploads/2022/07/GINA-Main-Report-2022-FINAL-22-07-01-WMS.pdf\u003c/span\u003e\u003cspan address=\"https://ginasthma.org/wp-content/uploads/2022/07/GINA-Main-Report-2022-FINAL-22-07-01-WMS.pdf\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. 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Essential Role of Pharmacists in Asthma Care and Management. J Pharm Pract. 2021;34(1):149\u0026ndash;62.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eElliott JP, Morphew T, Gentile D, Williams P, Barrett C, Sossong N. Improved asthma outcomes among at-risk children in a pharmacist-led, interdisciplinary school-based health clinic: A pilot study of the CAReS program. J Am Pharm Assoc. 2022;62(2):519\u0026ndash;25.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAlmomani BA, Mayyas RK, Ekteish FA, Ayoub AM, Ababneh MA, Alzoubi SA. The effectiveness of clinical pharmacist's intervention in improving asthma care in children and adolescents: Randomized controlled study in Jordan. Patient Educ Couns. 2017;100(4):728\u0026ndash;35.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eShdaifat MBM, Khasawneh RA, Alefan Q. Clinical and economic impact of telemedicine in the management of pediatric asthma in Jordan: a pharmacist-led intervention. J Asthma. 2022;59(7):1452\u0026ndash;62.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAmmari WG, Chrystyn H. Optimizing the inhalation flow and technique through metered dose inhalers of asthmatic adults and children attending a community pharmacy. J Asthma. 2013;50(5):505\u0026ndash;13.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eXaubet Olivera CM, Vianna EO, Bonizio RC, et al. Asthma self-management model: randomized controlled trial. Health Educ Res. 2016;31:639\u0026ndash;52.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eArmour CL, Reddel HK, LeMay KS, et al. Feasibility and effectiveness of an evidence based asthma service in Australian community pharmacies: a pragmatic cluster randomized trial. J Asthma. 2013;50(3):302\u0026ndash;9.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLin G, Chau CI, Hu H, Ung COL. Pharmacist intervention for pediatric asthma: A systematic literature review and logic model. Res Social Adm Pharm. 2023;19(12):1487\u0026ndash;510.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBarman A. Standard setting in student assessment: is a defensible method yet to come? Ann Acad Med Singap. 2008;37(11):957\u0026ndash;63.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMazi A, Madani F, Alsulami E, et al. Uncontrolled Asthma Among Children and Its Association With Parents' Asthma Knowledge and Other Socioeconomic and Environmental Factors. Cureus. 2023;15(2):e35240.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDivecha CA, Tullu MS, Jadhav DU. Parental knowledge and attitudes regarding asthma in their children: Impact of an educational intervention in an Indian population. Pediatr Pulmonol. 2020;55(3):607\u0026ndash;15.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eJones H, Lawton A, Gupta A. Asthma Attacks in Children-Challenges and Opportunities. Indian J Pediatr. 2022;89(4):373\u0026ndash;7.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDenlinger LC, Heymann P, Lutter R, Gern JE. Exacerbation-Prone Asthma. J Allergy Clin Immunol Pract. 2020;8(2):474\u0026ndash;82.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSarikloglou E, Fouzas S, Paraskakis E. Prediction of Asthma Exacerbations in Children. J Pers Med. 2023;14(1):20.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eTeach SJ, Gill MA, Togias A, et al. Preseasonal treatment with either omalizumab or an inhaled corticosteroid boost to prevent fall asthma exacerbations. J Allergy Clin Immunol. 2015;136(6):1476\u0026ndash;85.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGoddard BMM, Hutton A, Guilhermino M, McDonald VM. Parents' Decision Making During Their Child's Asthma Attack: Qualitative Systematic Review. J Asthma Allergy. 2022;15:1021\u0026ndash;33.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRing N, Jepson R, Hoskins G, et al. Understanding what helps or hinders asthma action plan use: a systematic review and synthesis of the qualitative literature. Patient Educ Couns. 2011;85(2):e131\u0026ndash;43.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eXi X, Huang Y, Lu Q, Ung COL, Hu H. Community pharmacists' opinions and practice of pharmaceutical care at chain pharmacy and independent pharmacy in China. Int J Clin Pharm. 2019;41(2):478\u0026ndash;87.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eChen H, Ung COL, Chi P, Wu J, Tang D, Hu H. Consumers' Perceptions About Pharmaceutical Care Provided by Community Pharmacists in China in Relation to Over-the-Counter Drugs: A Qualitative Study. Inquiry. 2018;55:46958018793292.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-primary-care","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"famp","sideBox":"Learn more about [BMC Primary Care](https://bmcprimcare.biomedcentral.com/)","snPcode":"","submissionUrl":"https://author-welcome.nature.com/12875","title":"BMC Primary Care","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"asthma, pharmaceutical care, pediatrics, family caregiver, survey","lastPublishedDoi":"10.21203/rs.3.rs-4581375/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4581375/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground\u003c/strong\u003e: Asthma brings a huge burden to children and their families. The aim of this study is to investigate the level of understanding of asthma among family caregivers, the burden they facing in caring for children with asthma, and their needs of pharmaceutical care.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods\u003c/strong\u003e: A questionnaireinformed by recent literature was distributed to family caregivers of children (\u0026lt;18 years old) diagnosed with asthma from Guangdong Province, China. Multiple linear regression analysis was used to identify the factors associated with the caregivers’ need of pharmaceutical care.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e: A total of 610 valid questionnaires were collected. Most of the participants were women (60%) or aged between 35 and 44 years (48%). Only 38.9% of participants believed that they had good asthma related knowledge. There were 59.2%of participants bearing high burden due to pediatric asthma, and 54.9% of the participants indicated great need for pharmaceutical intervention. The results of multiple linear regression showed that pharmaceutical care needs were significantly associated with their gender, age, duration of taking care of pediatric asthma patients, and overall burden (all \u003cem\u003ep\u003c/em\u003e\u0026lt;0.05).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusions\u003c/strong\u003e: Caregivers of pediatric asthma patients self-reported inadequate levels of asthma knowledge, high level of burden, and unmet needs for pharmaceutical care, all of which presented great opportunities for pharmacists to contribute to pediatric asthma management at the community level.\u003c/p\u003e","manuscriptTitle":"Exploring the perception and the needs of pharmaceutical care perceived by family caregivers of pediatric asthma patients in Guangdong Province, China: a cross-sectional survey study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-07-15 23:42:14","doi":"10.21203/rs.3.rs-4581375/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2024-06-20T09:42:45+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2024-06-18T01:06:24+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2024-06-18T01:05:33+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Primary Care","date":"2024-06-14T10:25:30+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-primary-care","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"famp","sideBox":"Learn more about [BMC Primary Care](https://bmcprimcare.biomedcentral.com/)","snPcode":"","submissionUrl":"https://author-welcome.nature.com/12875","title":"BMC Primary Care","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"3c5de64e-acd5-4c90-ad6d-4dd68b79ff2a","owner":[],"postedDate":"July 15th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2025-08-04T16:45:26+00:00","versionOfRecord":{"articleIdentity":"rs-4581375","link":"https://doi.org/10.1186/s12875-025-02936-5","journal":{"identity":"bmc-primary-care","isVorOnly":false,"title":"BMC Primary Care"},"publishedOn":"2025-08-02 16:21:41","publishedOnDateReadable":"August 2nd, 2025"},"versionCreatedAt":"2024-07-15 23:42:14","video":"","vorDoi":"10.1186/s12875-025-02936-5","vorDoiUrl":"https://doi.org/10.1186/s12875-025-02936-5","workflowStages":[]},"version":"v1","identity":"rs-4581375","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4581375","identity":"rs-4581375","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}