Improved quality-of-life of caregivers of children with asthma through guideline-based management.
OBJECTIVE
The quality of life (QOL) of caregivers of children with asthma may be related to children's responses to asthma management.


OBJECTIVE
To evaluate change in QOL over time of caregivers of children with asthma through guideline-based management.


METHODS
This was a 3-year prospective cohort study of children with asthma referred to our pediatric asthma center. Families completed Pediatric Asthma Caregiver's Quality of Life Questionnaire (PACQLQ), the Asthma Control Test™ (ACT), and reported the number of days/month of albuterol use and wheezing at each clinic visit.


RESULTS
We enrolled 143 children, ages 7-17 years (mean = 10.6 ± 2.9), 56.6% male, 70.6% Caucasian. Patients were managed by the same MD (n = 65,45.5%) or APN (n = 78,54.5%) over time. The mean total PACQLQ significantly increased over the 3-year period (F = 67.418, p < .001). Total scores at the first visit were 4.8 ± 1.6, which improved to 6.1 ± 1 at the 3-month follow-up visit. This improvement was sustained at the 1, 2, and 3-year clinic visits. PACQLQ emotional function (F = 60.798, p < .001) and activity limitation (F = 41.517, p < .001) domains significantly improved as well. PACQLQ scores were significantly associated with improved ACT scores (r = .37 to .47, p < .05), fewer days/month of albuterol use (r = -.25 to -.36., p < .05), and wheezing (r = -.28 to -.33, p < .05). There were no significant differences in PACQLQ, or asthma clinical outcome measures between MD and APN providers.


CONCLUSIONS
Use of National Asthma Education and Prevention Program (NAEPP) guidelines significantly improved QOL of caregivers of children with asthma and in asthma-related symptoms. Improvements over time were independent of type of providers.
a Department of Pediatrics , The Ohio State University College of Medicine , Columbus , OH , USA.|b Section of Pulmonary MedicineNationwide Children's Hospital , Columbus , OH , USA.|c Section of Allergy & Immunology , Nationwide Children's Hospital , Columbus , OH , USA.
Shahid I
SI
Sheikh
b Section of Pulmonary MedicineNationwide Children's Hospital , Columbus , OH , USA.
Judy
J
Pitts
b Section of Pulmonary MedicineNationwide Children's Hospital , Columbus , OH , USA.
Nancy A
NA
Ryan-Wenger
a Department of Pediatrics , The Ohio State University College of Medicine , Columbus , OH , USA.|b Section of Pulmonary MedicineNationwide Children's Hospital , Columbus , OH , USA.
Kavitha
K
Kotha
a Department of Pediatrics , The Ohio State University College of Medicine , Columbus , OH , USA.|b Section of Pulmonary MedicineNationwide Children's Hospital , Columbus , OH , USA.
Karen S
KS
McCoy
a Department of Pediatrics , The Ohio State University College of Medicine , Columbus , OH , USA.|c Section of Allergy & Immunology , Nationwide Children's Hospital , Columbus , OH , USA.
David R
DR
Stukus
D000293:Adolescent; D001249:Asthma / Q000503:physiopathology* / Q000628:therapy*; D001993:Bronchodilator Agents / Q000627:therapeutic use; D017028:Caregivers / Q000523:psychology*; D002648:Child; D004644:Emotions; D005260:Female; D006801:Humans; D008297:Male; D009722:Nurse Practitioners / Q000706:statistics & numerical data; D010353:Patient Education as Topic / Q000458:organization & administration*; D011446:Prospective Studies; D000072106:Pulmonologists / Q000706:statistics & numerical data; D011788:Quality of Life / Q000523:psychology*; D012720:Severity of Illness Index; D012959:Socioeconomic Factors
D001993:Bronchodilator Agents
Asthma; PACQLQ; children; quality of life