Treatment alliance and its association with family functioning, adherence,and medical outcome in adolescents with severe, chronic asthma

Objective: To examine the concept of treatment alliance in the care of adol escents with asthma. Methods: Measures of treatment alliance were obtained from 60 adolescents w ith severe, chronic asthma admitted to a tertiary care facility, their pare nts, and their asthma specialists at the referral center. Associations were examined between the alliance measures and multimeasure, multiagent data c oncerning family functioning and asthma treatment adherence and outcome. Results: Physicians' reports of treatment alliance were associated with con current family functioning and asthma medication adherence, as well as with asthma treatment adherence and outcome in the year after the stay at the a sthma center. Conclusions: As emphasized in the recently revised Expert Panel Report: Gui delines for the Diagnosis and Management of Asthma (NHLBI, 1997), the abili ty of children with asthma, their parents, and their physician to create a positive partnership, or treatment alliance, appears to have an important r ole in optimal asthma management.