Discovering differences in autonomy among patients with moderate to severe asthma

Published: November 13, 2021

Autonomy is a key principle of medical ethics. It is defined as the ability to make informed medical decisions that are free of coercion and align with one’s own values. Autonomy has a pivotal role in health care. In the pursuit of making health care increasingly equitable, it is important to understand autonomy so that patients from all backgrounds are able to engage in their own medical care. Yet, there is a shortage of research focusing on the role of medical ethics within the field of Allergy and Immunology. This study sought to further understand autonomy and patient characteristics that influence autonomy.

In a recent study published in The Journal of Allergy and Clinical Immunology: In Practice, Buckey et al conducted a study where 295 adults with moderate to severe asthma completed a 21-question assessment of autonomy. The assessment included questions on asthma medication and disease state understanding, medical decision making, and health care system understanding. Patient baseline characteristics were obtained through self-reporting. Linear regression was completed on the derived autonomy score predicted by patient characteristics.

Statistically significant lower autonomy scores were seen in individuals who listed Spanish as their primary language and in those with diabetes or depressive symptoms. Higher autonomy scores were seen in non-Hispanic White participants when compared with those of non-Hispanic Black participants. Higher scores were also observed in participants with higher functional health literacy. This study demonstrated autonomy is associated with comorbidities, demographics, and health literacy. These results may be related to variability in social, economic, and educational opportunities encountered by individuals from different backgrounds. This study also provided an initial step in adapting current and designing new treatment guidelines and interventions to improve patient autonomy and patient-centered care.

The Journal of Allergy and Clinical Immunology: In Practice is an official journal of the AAAAI, focusing on practical information for the practicing clinician.

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