Title: Caregiver-Reported Asthma Control Predicts Future Visits, Independent of Guideline-Based Control Measures.

Authors: Kochis, Suzanne R; Grant, Torie; Phipatanakul, Wanda; Perzanowski, Matthew; Balcer-Whaley, Susan; Curtin-Brosnan, Jean; Newman, Michelle; Cunningham, Amparito; Bollinger, Mary E; Matsui, Elizabeth C

Published In J Allergy Clin Immunol Pract, (2019)

Abstract: It is unknown whether caregiver perception of a child's asthma control, independent of guideline-based asthma control assessment, is a predictor of future acute visits.To determine whether caregiver-reported asthma control is an indicator of future risk of acute visit.Two study populations of low-income, minority 5- to 17-year-old children with persistent asthma were included. Questionnaires administered at baseline and at 3, 6, 9, and 12 months captured symptoms, short-acting β-agonist use, acute visits in the previous 3 months, and caregiver-reported asthma control. Well-controlled, not well-controlled, and very poorly controlled asthma were defined using National Asthma Education and Prevention Program guideline-based assessment. Relationships between caregiver-reported control and acute visits in the subsequent 3 months were examined.At baseline, both populations were predominantly black/African American (91% and 79%) with public insurance (85% and 88%) and very poorly controlled asthma (47% and 50%). In both populations, most caregivers reported that their child's asthma was well controlled (73% and 69%). In both populations, participants whose caregivers reported that their child had uncontrolled asthma had greater odds of having an acute visit in the following 3 months as compared with participants whose caregivers reported that their child's asthma was well controlled, independent of guideline-based control, age, sex, race, controller medication, insurance, and atopy (odds ratio [95% CI], 2.4 [1.4-4.2] and 1.6 [1.1-2.4]).Among predominantly low-income minority children with asthma, caregiver-reported asthma control may provide information about the risk of future acute visit for asthma that is complementary to guideline-based control assessment.

PubMed ID: 30703536

MeSH Terms: Adolescent; Ambulatory Care/statistics & numerical data*; Asthma/drug therapy; Asthma/physiopathology*; Baltimore; Black or African American; Bronchodilator Agents/therapeutic use; Caregivers*; Child; Child, Preschool; Disease Progression; Emergency Service, Hospital/statistics & numerical data*; Female; Hospitalization/statistics & numerical data*; Humans; Insurance, Health; Male; Minority Groups; Poverty; Severity of Illness Index