Parental and children’s perception of asthma control: modifiable factors, in a UK population

Abstract

Aims To evaluate the attitudes and behaviour of children and their parents in relation to childhood asthma in the UK. Methods The Room to Breathe survey included children and parents from 6 countries. 200 parental interviews from UK families were obtained. Respondents were randomly chosen from the general population; included were those with children aged 4–15 years with asthma. Results A total of 200 parents and 131 children were interviewed in the UK. The aim of asthma management is to provide control (as per BTS guidelines). In the 131 paired children/parent responses, control was obtained in 85/131 (65%). The opinions of parents and children are important in the perception of control. Statistical analysis using inter-rater agreement yielded a κ value = 0.047 indicating that children and parents are in poor agreement; they are only marginally better than chance at predicting the severity of their asthma. Information that had been provided to those interviewed was predominantly delivered by general practitioners (182/200 91%) and asthma nurses (100/200 50%). The most useful information was provided by asthma nurses, patient support groups and friends/family Of 196 respondents spacers were used in 106/196 (54%) with relievers and 87/196 (44%) with preventers. Of all respondents 50% (100/200) had made lifestyle changes in response to diagnosis; however, of all parents 61/200 (30%) still smoked. Conclusion Asthma control in the UK is still substandard. The perception of asthma severity is discrepant between child and parent, despite parental feeling that their children are honest with regard to their symptoms. In order to obtain control we need to look at modifiable factors and to choose information provided carefully to ensure maximal effect on implementing and sustaining change.