Impact of Gender of the Child on Quality of Life of Families of Children With Asthma: Long-Term Follow-Up

Abstract

SESSION TITLE: Pediatrics SESSION TYPE: Original Investigation Poster PRESENTED ON: Wednesday, November 1, 2017 at 01:30 PM - 02:30 PM PURPOSE: Uncontrolled asthma in a child can impair quality of life of caregivers. In pediatric age group, asthma prevalence is higher in males. It is not clear if gender of the child with asthma has any impact on parents’ quality of life. Aim: To document any gender disparities in QoL of families of children with asthma once their 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 pediatric quality of life survey (PACQLQ) was used to evaluate the impact of asthma on families over time. Children and caregivers who were seen in clinic at enrollment, and after every 3-6 months were included in this study (n=375). At each visit, the parents completed PACQLQ, Asthma Control Test (ACT), frequency of wheezing, and albuterol use since last visit. Results were compared between male and female patients with asthma over time. RESULTS: The sample included 375 children, ages 2-17 years (mean=6.3 ± 4.1). Male to female ratio was 61.6%:38.9%. Caucasians were 254, (67.7%), African Americans 85 (22.6%), Hispanics 26 (6.9%) and biracial 10 (2.6%). At initial visit, mean PACQLQ total, activity limitation, and emotional function scores in families of male children with asthma were not significantly different then families of female children with asthma (4.7±1.6, 4.7±1.9 and 4.7±1.6 compared to 4.8±1.7, 4.8±1.8 and 4.8±1.7 respectively (p=0.832, 0.854, 0.770 respectively). At three month follow-up, mean scores in families of male children with asthma improved to 6.0 ±1.1, 6.0±1.2 and 6.0±1.1 compared to 6.3±0.9, 6.3±1.0 and 6.3±0.9 in families of female children respectively. 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 between males and females with respect to overall PACQLQ total (F=.104, p=.748), Emotional Function (F= .187, p=.666), or Activity Limitation scores (F=.004, p=.950). At initial visit, median number of days/month albuterol use was 7 for both males and females which improved to 1 at three month follow up. Similarly mean ACT scores in males and females were 15.4±5.6 and 16.7±5.5 respectively and improved with time. Males had significantly more median days with wheezing at the first visit (10 compared to 5, p=.038) and at 3-month visit (p=.018) but there was no difference between groups for the remaining follow up. 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 number of days with wheezing and albuterol use. CONCLUSIONS: Parents quality of life as measured by PACQLQ and asthma control in children is independent of gender of the child. CLINICAL IMPLICATIONS: Gender of child has no significant impact on improvement in QOL in families of children with asthma once asthma guidelines are followed. DISCLOSURE: The following authors have nothing to disclose: Shahid Sheikh, Judy Pitts, Mehek Sheikh, Nancy Ryan-Wenger No Product/Research Disclosure Information