title: Uncontrolled asthma: assessing quality of life and productivity of children and their caregivers using a cross-sectional Internet-based survey.
abstract: BACKGROUND
  Results of a national survey of asthmatic children that evaluated management goals established in 2004 by the National Asthma Education and Prevention Program (NAEPP) indicated that asthma symptom control fell short on nearly every goal.
  
  
  METHODS
  An Internet-based survey was administered to adult caregivers of children aged 6-12 years with moderate to severe asthma. Asthma was categorized as uncontrolled when the caregiver reported pre-specified criteria for daytime symptoms, nighttime awakening, activity limitation, or rescue medication based on the NAEPP guidelines. Children's health-related quality of life (HRQOL) and caregivers' quality of life (QOL) were assessed using the Child Health Questionnaire Parent Form 28 (CHQ-PF28) and caregiver's work productivity using a modified Work Productivity and Activity Impairment Questionnaire. Children with uncontrolled vs. controlled asthma were compared.
  
  
  RESULTS
  360 caregivers of children with uncontrolled asthma and 113 of children with controlled asthma completed the survey. Children with uncontrolled asthma had significantly lower CHQ-PF28 physical (mean 38.1 vs 49.8, uncontrolled vs controlled, respectively) and psychosocial (48.2 vs 53.8) summary measure scores. They were more likely to miss school (5.5 vs 2.2 days), arrive late or leave early (26.7 vs 7.1%), miss school-related activities (40.6 vs 6.2%), use a rescue inhaler at school (64.2 vs 31.0%), and visit the health office or school nurse (22.5 vs 8.8%). Caregivers of children with uncontrolled asthma reported significantly greater work and activity impairment and lower QOL for emotional, time-related and family activities.
  
  
  CONCLUSIONS
  Poorly controlled asthma symptoms impair HRQOL of children, QOL of their caregivers, and productivity of both. Proper treatment and management to improve symptom control may reduce humanistic and economic burdens on asthmatic children and their caregivers.
authors.affiliation: Cerner LifeSciences, Beverly Hills, CA, USA. bdean@cerner.com
authors.forename: Bonnie B
authors.initials: BB
authors.lastname: Dean
authors.forename: Brian C
authors.initials: BC
authors.lastname: Calimlim
authors.forename: Patricia
authors.initials: P
authors.lastname: Sacco
authors.forename: Daniel
authors.initials: D
authors.lastname: Aguilar
authors.forename: Robert
authors.initials: R
authors.lastname: Maykut
authors.forename: David
authors.initials: D
authors.lastname: Tinkelman
mesh_terms: D000328:Adult; D001249:Asthma / Q000150:complications / Q000503:physiopathology / Q000523:psychology; D017028:Caregivers / Q000523:psychology*; D002648:Child; D003430:Cross-Sectional Studies; D004526:Efficiency; D005260:Female; D006305:Health Status Indicators; D006306:Health Surveys; D006801:Humans; D020407:Internet; D008297:Male; D011788:Quality of Life / Q000523:psychology*; D012042:Registries; D012720:Severity of Illness Index; D013315:Stress, Psychological; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014481:United States
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