Parents and adolescents preferences for asthma control: a best-worst scaling choice experiment using an orthogonal main effects design.

Wendy J Ungar,Nicole W Tsao,Larry D Lynd,Mehdi Najafzadeh,Sharon Dell,Anahita Hadioonzadeh

doi:10.1186/s12890-015-0141-9

Abstract

BackgroundThe preferences of parents and children with asthma influence their ability to manage a child’s asthma and achieve good control. Potential differences between parents and adolescents with respect to specific parameters of asthma control are not considered in clinical asthma guidelines. The objective was to measure and compare the preferences of parents and adolescents with asthma with regard to asthma control parameters using best worst scaling (BWS).MethodsFifty-two parents of children with asthma and 44 adolescents with asthma participated in a BWS study to quantify preferences regarding night-time symptoms, wheezing/chest tightening, changes in asthma medications, emergency visits and physical activity limitations. Conditional logit regression was used to determine each group’s utility for each level of each asthma control parameter.ResultsParents displayed the strongest positive preference for the absence of night-time symptoms (β = 2.09, p < 0.00001) and the strongest negative preference for 10 emergency room visits per year (β = −2.15, p < 0.00001). Adolescents displayed the strongest positive preference for the absence of physical activity limitations (β = 2.17, p < 0.00001) and the strongest negative preference for ten physical activity limitations per month (β = −1.97). Both groups were least concerned with changes to medications.ConclusionParents and adolescents placed different weights on the importance of asthma control parameters and each group displayed unique preferences. Understanding the relative importance placed on each parameter by parents and adolescents is essential for designing effective patient-focused disease management plans.Electronic supplementary materialThe online version of this article (doi:10.1186/s12890-015-0141-9) contains supplementary material, which is available to authorized users.

Highlights

The preferences of parents and children with asthma influence their ability to manage a child’s asthma and achieve good control
Twenty-six percent of the children of parent respondents used combination long-acting beta agonist plus inhaled corticosteroid medications compared to 59 % of adolescents, the former group represents younger children for whom combination inhalers may not be indicated
The results indicate that parents had the strongest positive preference for the absence of night-time symptoms (β = 2.09, p < 0.00001), which was greater than their preference for Parent report of child’s physical activity compared with other children of same age Much more active Moderately more active active Moderately less active Not sure

Summary

Introduction

The preferences of parents and children with asthma influence their ability to manage a child’s asthma and achieve good control. Potential differences between parents and adolescents with respect to specific parameters of asthma control are not considered in clinical asthma guidelines. The objective was to measure and compare the preferences of parents and adolescents with asthma with regard to asthma control parameters using best worst scaling (BWS). Despite the availability of asthma guidelines [1,2,3], achieving control continues to be challenging for children, parents and health providers [4,5,6,7,8]. The study objectives were to measure and compare the preferences of parents of young children with asthma and adolescents with asthma regarding attributes of asthma control

Methods

Results

Discussion

Conclusion