March 5th, 2019
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.