Uncontrolled asthma: assessing quality of life and productivity of children and their caregivers using a cross-sectional Internet-based survey.
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.
Dean
Bonnie B
BB
Cerner LifeSciences, Beverly Hills, CA, USA. bdean@cerner.com
Calimlim
Brian C
BC
Sacco
Patricia
P
Aguilar
Daniel
D
Maykut
Robert
R
Tinkelman
David
D
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
J Sch Health. 2006 Jan;76(1):18-24
16457681
J Epidemiol Community Health. 2005 Jan;59(1):75-82
15598731
Ann Fam Med. 2008 Jan-Feb;6 Suppl 1:S16-22
18195302
J Chronic Dis. 1987;40(2):171-8
3818871
Vital Health Stat 10. 2007 Sep;(234):1-79
17969822
Patient Educ Couns. 2009 May;75(2):162-8
19036553
Eur J Health Econ. 2009 Feb;10(1):5-13
18256865
Ann Allergy Asthma Immunol. 2007 Mar;98(3):245-51
17378255
Vaccine. 2009 Feb 5;27(6):815-8
19059447
Value Health. 2009 Sep;12(6):1011-7
19402853
Prim Care Respir J. 2010 Mar;19(1):3-9
19834632
Eur Respir J. 2007 Jan;29(1):56-62
17050557
J Occup Environ Med. 2009 Jul;51(7):780-5
19528828
Arch Pediatr Adolesc Med. 2000 Sep;154(9):923-8
10980797
Am J Respir Crit Care Med. 2004 Oct 15;170(8):836-44
15256389
Alcohol Clin Exp Res. 2008 Feb;32(2):222-9
18162076
Aliment Pharmacol Ther. 2004 Aug 15;20(4):459-67
15298641
Eur Respir J. 2008 Feb;31(2):320-5
17959642
Ann Allergy Asthma Immunol. 2008 Feb;100(2):112-9
18320912
Med Care. 2003 May;41(5):582-92
12719681