Caregiver-reported asthma control predicts future visits, independent of guideline-based control measures

Publication date: Available online 28 January 2019

Source: The Journal of Allergy and Clinical Immunology: In Practice

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

Abstract

Background

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.

Objective

To determine if caregiver-reported asthma control is an indicator of future risk of acute visit.

Methods

Two study populations of low income, minority 5-17 year old children with persistent asthma were included. Questionnaires administered at baseline, 3, 6, 9, and 12 months captured symptoms, short-acting beta-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 (NAEPP) guideline-based assessment. Relationships between caregiver-reported control and acute visits in the subsequent 3 months were examined.

Results

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, the majority of 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 to 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 (OR [95% CI]: 2.4 [1.4 – 4.2] and 1.6 [1.1 – 2.4]).

Conclusion

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.

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