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Caregiver-reported asthma control predicts future asthma visits

Published online: January 28, 2019

Parents (or caregivers) play a major role in assessing and managing their children’s asthma, yet guidelines for managing asthma emphasize symptom frequency and do not formally incorporate parental or caregiver perception of how well their child’s asthma is controlled.  In a recent study published in The Journal of Allergy and Clinical Immunology: In Practice, Kochis et al assessed whether caregivers’ perceptions of their child’s asthma control predicted future asthma visits across two study populations of low-income, minority children ages 5-17 with persistent asthma.  

Kochis et al analyzed data from two studies addressing childhood asthma (The Mouse Allergen and Asthma Cohort Study and the Mouse Allergen and Asthma Intervention Trial).  Both studies included low-income, minority children with persistent asthma ages 5-17 years.  Participants answered questionnaires at baseline and at 3, 6, 9 and 12 months, which included a question directed at caregivers about whether they thought their child’s asthma was well controlled or not (caregiver-reported asthma control).  The child’s asthma control was also defined using National Asthma Education and Prevention Program guideline-based assessments (guideline-based asthma control).  Relationships between caregiver-reported control and acute visits in the subsequent 3 months were examined.  

The authors found that participants whose caregivers reported that their child had uncontrolled asthma were more likely to have an acute visit for asthma in the following 3 months as compared to those whose caregivers reported that their child’s asthma was well controlled.  This relationship remained even after taking guideline-based asthma control, age, sex, race, controller medication, insurance and atopy into account.  

Current asthma guidelines do not explicitly recommend assessment of caregiver perception of the child’s asthma control.  This study suggests that caregiver-reported asthma control may provide information about the risk of future asthma visits that is complementary to guideline-based control assessment.  This is especially important as we move toward greater recognition of the importance of patient-centered outcomes, as it may be important to consider how to integrate caregiver perception of control into asthma management guidelines.  

The Journal of Allergy and Clinical Immunology: In Practice is an official journal of the AAAAI, focusing on practical information for the practicing clinician.