Symptom monitoring and quality of life in children with asthma: Scope for self-management in routine care

Abstract

Objectives: To observe correlation between parental and child reporting of change in asthma symptoms and objective parameters of lung function over time. Design: Prospective cohort study. Materials and Methods: Children (n = 125) were divided into two age groups (6-10 years and 11-15 years) and were classified into intermittent, mild persistent, and moderate persistent grades of severity. Parental and child reporting of quality of life (QoL) scores were recorded on a pretested questionnaire on the initial visit and at 4 and 8 weeks. At each session, appropriate counseling regarding the disease and its primary management at home was done. The change in scores from first and second follow-up visits was statistically correlated with changes in symptom score recorded on symptom diary, peak expiratory flow rates (PEFR), and spirometry. Results : There was significant improvement in the subjective and objective parameters compared at the two follow-up visits. The magnitude of improvement in parental global rating of QOL was similar to improvement in objective measures of pulmonary function in children 6-10 years of age, whereas both parental and child rating correlated well with objective parameters in children 11-15 years of age. Also, symptom score emerged as a stronger predictor of acute exacerbation in PEFR in candidate children who had breakthrough attacks. Conclusion: Improvement in QoL score is a sensitive measure of functional improvement in asthmatic children on treatment and may complement objective measurements. Health education has a positive impact on treatment outcome. Self monitoring of symptoms at home fosters more patient involvement and promotes better management at all levels of care.