Asthma outcomes in children and adolescents with multiple morbidities: Findings from the National Health Interview Survey

Abstract

More Americans are managing multiple chronic conditions (MCCs), and trends are particularly alarming in youth. The purpose of this study was to examine the prevalence and distribution of 9 chronic conditions in children and adolescents with and without asthma, and adverse asthma outcomes associated with having MCCs. Cross-sectional interview data from the National Health Interview Survey were analyzed (N = 66,790) between 2007 and 2012 in youth 0 to 17 years of age. Bivariate analysis methods and multivariate generalized linear regression were used to examine associations. Five percent of children with asthma had 1 or more coexisting health conditions. The prevalence of 1 or more comorbidities was greater among those with asthma than those without (5.07% [95% CI: 4.5-5.6] vs. 2.73% [95% CI: 2.6-2.9]). Those with asthma were twice as likely to have co-occurring hypertension (prevalence ratio [PR] = 2.2 [95% CI: 1.5-3.2]) and arthritis (PR = 2.7 [95% CI: 1.8-4.0]) compared with those without asthma. Every additional chronic condition with asthma was associated with a greater likelihood of an asthma attack (PR = 1.1 [95% CI: 1.0-1.2]), all-cause emergency department visits (PR = 1.3 [95% CI: 1.1-1.5]), and missed school days (PR = 2.3 [95% CI: 1.7-3.2]). Children and adolescents with asthma in the US who suffer from MCCs have increased asthma symptoms, missed school days, and all-cause emergency department visits. Further research on optimal management strategies for this group is needed.