Caregiver report of child’s asthma control predicts future acute visits in a mouse-sensitized population, independent of guideline-based measures of asthma control
Monday, March 5, 2018
South Hall A2 (Convention Center)
Suzanne L. Rossi, MD, Torie L. Grant, MD, Wanda Phipatanakul, MD MS FAAAAI, Matthew Perzanowski, PhD, Susan L. Balcer-Whaley, MPH, Jean Curtin-Brosnan, MA, Michelle Newman, RN, Amparito Cunningham, MD MPH, Mary Beth Bollinger, DO, Elizabeth Matsui, MD MHS
RATIONALE: Parent-reported asthma control, which is not included in many rubrics for assessing asthma control, may be an indicator of future risk.

METHODS: 350 mouse sensitized and exposed children (5-17y) from Baltimore and Boston with persistent asthma enrolled in a randomized clinical trial were studied. Questionnaires were administered at baseline, 3, 6, 9, and 12 months, spirometry was performed at baseline, 6 and 12 months, and allergy skin testing at baseline. Controlled, uncontrolled, and poorly controlled asthma were defined using National Asthma Education and Prevention Program (NAEPP) guidelines (symptom days, activity limitation, albuterol use, nighttime awakenings in the past two weeks, FEV1/FVC and acute visits in the past 3 months). Relationships between caregiver-reported control and acute visits in the subsequent 3 months were examined using logistic regression and generalized estimating equations.

RESULTS: 38% were female, 79% African American and 88% had public insurance. 47% of participants were categorized as not well controlled, and 44% as poorly controlled. 25% of parents reported that their child’s asthma was not well controlled. Participants whose caregivers reported uncontrolled asthma had a 1.7-fold greater odds of having an acute visit in the subsequent 3 months than those whose caregivers reported that their child’s asthma was controlled (95% CI 1.2 – 2.3). The odds ratio remained similar after adjusting for guideline-based control, age, sex, race, controller medication, insurance type, and atopy (OR 1.7; 95% CI 1.2 – 2.4).

CONCLUSIONS: In this population, caregiver-reported asthma control is a predictor of future acute asthma visits, independent of guideline-based asthma control measures.