The parental burden of a preschooler asthma flare-up

Published Online: October 15, 2015

The majority of exacerbations in the preschool age group are managed in the home setting where the burden of care rests with the caregiver. A flare-up may thus cause considerable disturbance to the parents’ normal responsibilities and functional status. Measuring the parental burden of caring for a preschooler during an acute exacerbation would provide an important and complementary outcome to assess response to therapy. Few valid instruments are available for this very purpose, particularly in this age group.   

Recently published in The Journal of Allergy and Clinical Immunology (JACI), Jensen and colleagues report the systematic development and validation of the Effects of a Child’s Asthma Flare-up on the Parents (ECAP), an instrument to measure functional status in caregivers of acutely ill preschoolers with asthma. The performance of the 21-item ECAP was tested in a therapeutic, randomized, placebo-controlled trial in children aged 1-6 years, with viral-induced asthma. The ECAP was completed by the caregiver on the last day their child exhibited symptoms of an episode triggered by a cold. The mean of all items, scored on a scale of 1 (best) to 7 (worst), provided the final score.

Simultaneously developed in the French and English language, the ECAP demonstrates the desired properties of a valid evaluative instrument. The ECAP score can distinguish between an asthma flare-up versus a cold and between asthma flare-ups requiring health care utilization and those that do not. Importantly, the ECAP demonstrates therapeutic responsiveness, detecting a higher functional status in caregivers of children allocated to the effective intervention compared to the placebo group. The ECAP can thus be applied in future trials to adequately measure the burden of a preschooler’s asthma flare-up on the caregiver.

Understanding the impact of a young child’s asthma flare-up on the parent is an important outcome for any intervention trial aimed at reducing the frequency and/or severity of asthma flare-ups in preschoolers. The ECAP is offered as a valid instrument to measure caregiver functional status during their preschooler’s asthma exacerbation, bringing a complementary perspective to traditional outcomes in therapeutic trials.

The Journal of Allergy and Clinical Immunology (JACI) is an official scientific journal of the AAAAI, and is the most-cited journal in the field of allergy and clinical immunology.

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