Reported Asthma Control Predicts Future Visits, Independent of Guideline-Based Control Measures

Abstract

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AAP Policy SupplementsSupplements Publish Supplement MultimediaVideo Abstracts Pediatrics On Call Podcast Subscribe Alerts Careers We will not be accepting article comments until November 8, 2021, while our site undergoes major changes. We apologize for the inconvenience. For questions, contact the editorial office. Asthma Reported Asthma Control Predicts Future Visits, Independent of Guideline-Based Control Measures Nicole B. Ramsey and Scott Sicherer Pediatrics December 2020, 146 (Supplement 4) S366; DOI: https://doi.org/10.1542/peds.2020-023861UUU Nicole B. Ramsey New York, New YorkFind this author on Google ScholarFind this author on PubMedSearch for this author on this siteScott Sicherer New York, New YorkFind this author on Google ScholarFind this author on PubMedSearch for this author on this site ArticleInfo & MetricsComments Download PDF SR Kochis, T Grant, W Phipatanakul. J Allergy Clin Immunol Pract. 2019;7(5):1516–1521.e1PURPOSE OF THE STUDY:This study assessed how a caregiver’s perception of their child’s asthma control might impact the child’s risk for having future urgent visits for asthma care.STUDY POPULATION:Two cohorts of low income, ethnic minority children in Baltimore or Boston from the Mouse Allergen and Asthma Cohort Study (MAACS) and the Mouse Allergen and Asthma Intervention Trial (MAAIT) with persistent asthma, aged 5 to 17 years were included. The MAACS study correlated mouse exposure with asthma features, while the MAAIT study evaluated pest control education and management on asthma morbidity.METHODS:Subjects were given surveys at baseline and quarterly for one year to assess for symptoms, bronchodilator use, urgent visit frequency, and asthma control. Guideline-based asthma control was assessed with the National Asthma Education and Prevention Program (NAEPP) tool. Caregiver assessment was analyzed in comparison with future acute visits at each quarterly interval. Acute visits were defined as a composite of emergency department visits, hospitalizations, and unscheduled doctor’s visits in this study.RESULTS:Subjects were primarily Black (79% to 91%) and had public health insurance (85% to 88%). Discordance was noted between NAEPP guideline (GA) and caregiver (CA)-based assessment of asthma; about half of the subjects had very poorly controlled asthma (as described by NAEPP, 47% to 50%), while about one third of parents rated their child’s asthma as uncontrolled (27% to 31%). Patients with CA poorly controlled asthma were more likely to have increased acute visits in the following quarter as compared with children who had CA controlled asthma (odds ratio [OR], 1.7–2.4). This increased risk persisted when controlling for guideline-based control assessment, age, sex, race, insurance type, maintenance medications, and other atopic conditions (OR, 1.5–2.4).CONCLUSIONS:CA asthma control among socioeconomically disadvantaged children may predict a child’s risk for an urgent visit in subsequent months. CA of asthma control might provide information that is independent of control measures based on national guidelines.REVIEWER COMMENTS:This study provides evidence to support the importance of CA of asthma control in predicting a child’s risk of an unscheduled medical visit. Previous studies have shown that GA does not adequately predict subsequent control. In this study, NAEPP GA of asthma control was less-significantly associated with future acute visits. Future studies should test tools that incorporate CA of control into management algorithms to complement current practices. A child’s perception of their own asthma control is another likely complementary vantage-point to be included in future studies.Copyright © 2020 by the American Academy of Pediatrics PreviousNext Back to top Advertising Disclaimer » In this issue Pediatrics Vol. 146, Issue Supplement 4 1 Dec 2020 Table of ContentsIndex by author View this article with LENS PreviousNext Email Article Thank you for your interest in spreading the word on American Academy of Pediatrics.NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address. Your Email * Your Name * Send To * Enter multiple addresses on separate lines or separate them with commas. 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Ramsey, Scott Sicherer Pediatrics Dec 2020, 146 (Supplement 4) S366; DOI: 10.1542/peds.2020-023861UUU Citation Manager Formats BibTeXBookendsEasyBibEndNote (tagged)EndNote 8 (xml)MedlarsMendeleyPapersRefWorks TaggedRef ManagerRISZotero Share Reported Asthma Control Predicts Future Visits, Independent of Guideline-Based Control Measures Nicole B. Ramsey, Scott Sicherer Pediatrics Dec 2020, 146 (Supplement 4) S366; DOI: 10.1542/peds.2020-023861UUU Share This Article: Copy Print Download PDF Insight Alerts Table of Contents Jump to section ArticlePURPOSE OF THE STUDY:STUDY POPULATION:METHODS:RESULTS:CONCLUSIONS:REVIEWER COMMENTS:Info & MetricsComments Related ArticlesNo related articles found.Google Scholar Cited By...No citing articles found.Google Scholar More in this TOC SectionAsthma Prevalence of Continuous Pulse Oximetry Monitoring in Hospitalized Children With Bronchiolitis Not Requiring Supplemental Oxygen Lung Computational Models and the Role of the Small Airways in Asthma Increased Capsaicin Sensitivity in Patients With Severe Asthma Is Associated With Worse Clinical Outcome Show more Asthma Diagnosis and Management Telehealth Delivery of Adherence and Medication Management System Improves Outcomes in Inner-City Children With Asthma Association Between Fungal Spore Exposure in Inner-City Schools and Asthma Morbidity The Projected Economic and Health Burden of Uncontrolled Asthma in the United States Show more Diagnosis and Management Similar Articles Journal Info Editorial Board Editorial Policies Overview Licensing Information Authors/Reviewers Author Guidelines Submit My Manuscript Open Access Reviewer Guidelines Librarians Institutional Subscriptions Usage Stats Support Contact Us Subscribe Resources Media Kit About International Access Terms of Use Privacy Statement FAQ AAP.org shopAAP Follow American Academy of Pediatrics on Instagram Visit American Academy of Pediatrics on Facebook Follow American Academy of Pediatrics on Twitter Follow American Academy of Pediatrics on Youtube RSS © 2021 American Academy of Pediatrics