OBJECTIVES: Teach-back method means asking patients to describe how they are going to follow instructions. It is one of the highly promoted health literacy strategies. Previous studies showed that vast majority of asthma patients misuse their inhalers. Therefore, confirming patients’ understanding of using the inhalers is crucial to improve health care quality. The aim of this study is to assess the association of using Teach-Back method and asthma patients’ reported quality of care using nationally representative data in the United States.

METHODS: Data came from Medical Expenditure Panel Survey (MEPS) 2013 to 2016 full year consolidated data, and included people who were diagnosed with asthma, and had used acute press inhaler in the last three months, and aged over 18 years. Main independent variable is whether the physician asked the patient to Teach-Back instructions. Dependent variable is patients’ overall rating of the health care quality. Multiple logistic regressions were conducted to see the association between using Teach-Back method and patients’ quality rating.

RESULTS: The study included 2502 asthma patients. 624 of them had never been asked to Teach-Back instructions by their providers, and 1878 patients reported being asked to Teach-Back instructions. Older adults, people with low levels of education, people with low income, and racial and ethnic minority group members were more likely to report being asked to Teach-Back instructions than more advantaged groups. There was significant association between using Teach-Back method and patients’ overall rating of health care quality. Controlling for patients’ demographic variables, patients who had been asked to Teach-Back were 2.1 times more likely to give a good quality rating than those who were never asked to Teach-Back (95% CI:1.748 to 2.632; p<0.001).

CONCLUSIONS: Adopting Teach-Back method may contribute to better quality rating by asthma patients. Greater efforts should be made to improve providers’ communication skills to ensure asthma patients’ understanding.