Impact of Age of the Child on Quality of Life of Families of Children With Asthma

Abstract

SESSION TITLE: Pediatrics SESSION TYPE: Original Investigation Poster PRESENTED ON: Wednesday, November 1, 2017 at 01:30 PM - 02:30 PM PURPOSE: Measuring quality of life in families is a useful tool in monitoring asthma in children. Currently Pediatric Asthma Caregiver’s Quality of Life Questionnaire (PACQLQ) is recommended only to be used in families with children ages 7-17 years even though younger children (ages 2-6 years) have more morbidity. It is not used in younger age group as it was assumed that parents of younger children may experience different issues then parents of older age. Aim: To identify usefulness of PACQLQ among parents of younger children (ages 2-6 years) with asthma by comparing their responses with responses of parents of older children (ages 7-17 years) with asthma over time once asthma is managed as per NAEPP (EPR-3) guidelines. METHODS: This was a 4 year prospective cohort study. After IRB approval, children were enrolled in our pediatric asthma center since 2011 (n= 868), and were provided asthma care as per NAEPP guidelines. A validated survey (PACQLQ) was used to evaluate the impact of asthma on families. Children (> 2 years of age) and caregivers who were seen in clinic at enrollment, and after every 3-6 months were included in this study (n=364). At each visit, the parents completed PACQLQ, ACT and symptom score since last visit. Results were compared over time between two age groups namely younger children ages 2-6 years old (n=213) and older children ages 7-17 years (n=151). RESULTS: The sample included 364 children. Male to female ratio was 61%:39%. Among younger children, mean age was 3.7±1.5 compared to 10.6±2.9 among older children. At initial visit, mean PACQLQ total, activity limitation, and emotions scores in families of younger children with asthma were not significantly different from responses of families of older children (4.1±2.1, 4.6±2.1 and 5.2±2.1 compared to 4.3±2.1, 4.7±2.2 and 5.2±2 respectively, p=.0.8, 0.8, 0.77 respectively). At three month follw-up, mean scores improved to 5.8 ±1.5, 5.9±1.5 and 6.3±1.2 compared to 5.9±1.3, 6.2±1.2 and 6.2±1.2 respectively in both groups. Linear mixed model analysis indicated significant overall improvement in PACQLQ total, Emotional Function, and Activity Limitation scores over the 4-year time period (all p<.001), but no significant differences were noted between groups with respect to overall PACQLQ total (F=.110, p=.732), Emotional Function (F= .172, p=.612), or Activity Limitation scores (F=.066, p=.820). At initial visit mean ACT scores were 15.6±6.1 and 16.2±5.5 respectively and median days/month with wheezing were 9 and 10. Both groups significantly improved over time without any significant difference between the groups. Improvement in PACQLQ total, emotion and activity in both groups over time correlated with improvement in ACT scores and decrease in number of days with wheezing. CONCLUSIONS: PACQLQ responses at baseline and changes over time in families of children with asthma ages 7-17 were similar to responses in families of younger children with asthma ages 2-6 years and changes correlated with changes in asthma symptoms and ACT over time. CLINICAL IMPLICATIONS: Age of the child has no significant impact on patterns of improvement in QOL in families of children with asthma over time thus PACQLQ can be used in families of younger children with asthma. DISCLOSURE: The following authors have nothing to disclose: Shahid Sheikh, Judy Pitts, Mehek Sheikh, Nancy Ryan-Wenger No Product/Research Disclosure Information