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Published in: Health and Quality of Life Outcomes 1/2010

Open Access 01-12-2010 | Research

Uncontrolled asthma: assessing quality of life and productivity of children and their caregivers using a cross-sectional Internet-based survey

Authors: Bonnie B Dean, Brian C Calimlim, Patricia Sacco, Daniel Aguilar, Robert Maykut, David Tinkelman

Published in: Health and Quality of Life Outcomes | Issue 1/2010

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Abstract

Background

Results of a national survey of asthmatic children that evaluated management goals established in 2004 by the National Asthma Education and Prevention Program (NAEPP) indicated that asthma symptom control fell short on nearly every goal.

Methods

An Internet-based survey was administered to adult caregivers of children aged 6-12 years with moderate to severe asthma. Asthma was categorized as uncontrolled when the caregiver reported pre-specified criteria for daytime symptoms, nighttime awakening, activity limitation, or rescue medication based on the NAEPP guidelines. Children's health-related quality of life (HRQOL) and caregivers' quality of life (QOL) were assessed using the Child Health Questionnaire Parent Form 28 (CHQ-PF28) and caregiver's work productivity using a modified Work Productivity and Activity Impairment Questionnaire. Children with uncontrolled vs. controlled asthma were compared.

Results

360 caregivers of children with uncontrolled asthma and 113 of children with controlled asthma completed the survey. Children with uncontrolled asthma had significantly lower CHQ-PF28 physical (mean 38.1 vs 49.8, uncontrolled vs controlled, respectively) and psychosocial (48.2 vs 53.8) summary measure scores. They were more likely to miss school (5.5 vs 2.2 days), arrive late or leave early (26.7 vs 7.1%), miss school-related activities (40.6 vs 6.2%), use a rescue inhaler at school (64.2 vs 31.0%), and visit the health office or school nurse (22.5 vs 8.8%). Caregivers of children with uncontrolled asthma reported significantly greater work and activity impairment and lower QOL for emotional, time-related and family activities.

Conclusions

Poorly controlled asthma symptoms impair HRQOL of children, QOL of their caregivers, and productivity of both. Proper treatment and management to improve symptom control may reduce humanistic and economic burdens on asthmatic children and their caregivers.
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Literature
1.
go back to reference Bloom B, Cohen RA: Summary health statistics for U.S. children: National Health Interview Survey, 2006. Vital Health Stat 2007, 10: 1–87. Bloom B, Cohen RA: Summary health statistics for U.S. children: National Health Interview Survey, 2006. Vital Health Stat 2007, 10: 1–87.
2.
go back to reference Owens PL, Thompson J, Elixhauser A, Ryan K: Care of Children and Adolescents on US Hospitals. HCUP Fact Book No. 4. AHRQ Publication No. 04–0004. Department of Health and Human Services. 2003. 7–5-2007 Owens PL, Thompson J, Elixhauser A, Ryan K: Care of Children and Adolescents on US Hospitals. HCUP Fact Book No. 4. AHRQ Publication No. 04–0004. Department of Health and Human Services. 2003. 7–5-2007
3.
go back to reference Environmental Hazards and Health Effects: Asthma's Impact on Children and Adolescents. Department of Health and Human Services, Centers for Disease Control and Prevention 2002. Environmental Hazards and Health Effects: Asthma's Impact on Children and Adolescents. Department of Health and Human Services, Centers for Disease Control and Prevention 2002.
4.
go back to reference Diette GB, Markson L, Skinner EA, Nguyen TT, Algatt-Bergstrom P, Wu AW: Nocturnal asthma in children affects school attendance, school performance, and parents' work attendance. Arch Pediatr Adolesc Med 2000, 154: 923–928.PubMedCrossRef Diette GB, Markson L, Skinner EA, Nguyen TT, Algatt-Bergstrom P, Wu AW: Nocturnal asthma in children affects school attendance, school performance, and parents' work attendance. Arch Pediatr Adolesc Med 2000, 154: 923–928.PubMedCrossRef
5.
go back to reference Asthma Prevalence, Health Care Use and Mortality, 2002. National Center for Health Statistics, Centers for Disease Control 2002. Asthma Prevalence, Health Care Use and Mortality, 2002. National Center for Health Statistics, Centers for Disease Control 2002.
6.
go back to reference The Costs of Asthma; Asthma and Allergy Foundation 1992 and 1998 Study 2000. The Costs of Asthma; Asthma and Allergy Foundation 1992 and 1998 Study 2000.
7.
go back to reference Pedersen S: From asthma severity to control: a shift in clinical practice. Prim Care Respir J 2010, 19: 3–9. 10.4104/pcrj.2009.00059PubMedCrossRef Pedersen S: From asthma severity to control: a shift in clinical practice. Prim Care Respir J 2010, 19: 3–9. 10.4104/pcrj.2009.00059PubMedCrossRef
8.
go back to reference Bateman ED, Bousquet J, Keech ML, Busse WW, Clark TJ, Pedersen SE: The correlation between asthma control and health status: the GOAL study. Eur Respir J 2007, 29: 56–62. 10.1183/09031936.00128505PubMedCrossRef Bateman ED, Bousquet J, Keech ML, Busse WW, Clark TJ, Pedersen SE: The correlation between asthma control and health status: the GOAL study. Eur Respir J 2007, 29: 56–62. 10.1183/09031936.00128505PubMedCrossRef
10.
go back to reference NAEPP (National Asthma Education and Prevention Program). Guidelines for the Diagnosis and Management of Asthma, Update on Selected Topics Bethesda, MD. National Institutes of Health. National Heart, Lung, and Blood Institute; 2002. NAEPP (National Asthma Education and Prevention Program). Guidelines for the Diagnosis and Management of Asthma, Update on Selected Topics Bethesda, MD. National Institutes of Health. National Heart, Lung, and Blood Institute; 2002.
11.
go back to reference NAEPP (National Asthma Education and Prevention Program). Guidelines for the Diagnosis and Management of Asthma, Full Report 2007 Bethesda, MD. National Institutes of Health. National Heart, Lung, and Blood Institute; 2007. NAEPP (National Asthma Education and Prevention Program). Guidelines for the Diagnosis and Management of Asthma, Full Report 2007 Bethesda, MD. National Institutes of Health. National Heart, Lung, and Blood Institute; 2007.
12.
go back to reference Raat H, Botterweck AM, Landgraf JM, Hoogeveen WC, Essink-Bot ML: Reliability and validity of the short form of the child health questionnaire for parents (CHQ-PF28) in large random school based and general population samples. J Epidemiol Community Health 2005, 59: 75–82. 10.1136/jech.2003.012914PubMedCentralPubMedCrossRef Raat H, Botterweck AM, Landgraf JM, Hoogeveen WC, Essink-Bot ML: Reliability and validity of the short form of the child health questionnaire for parents (CHQ-PF28) in large random school based and general population samples. J Epidemiol Community Health 2005, 59: 75–82. 10.1136/jech.2003.012914PubMedCentralPubMedCrossRef
13.
go back to reference Reilly MC, Bracco A, Ricci JF, Santoro J, Stevens T: The validity and accuracy of the Work Productivity and Activity Impairment questionnaire--irritable bowel syndrome version (WPAI:IBS). Aliment Pharmacol Ther 2004, 20: 459–467. 10.1111/j.1365-2036.2004.02091.xPubMedCrossRef Reilly MC, Bracco A, Ricci JF, Santoro J, Stevens T: The validity and accuracy of the Work Productivity and Activity Impairment questionnaire--irritable bowel syndrome version (WPAI:IBS). Aliment Pharmacol Ther 2004, 20: 459–467. 10.1111/j.1365-2036.2004.02091.xPubMedCrossRef
14.
go back to reference Kronborg C, Handberg G, Axelsen F: Health care costs, work productivity and activity impairment in non-malignant chronic pain patients. Eur J Health Econ 2009, 10: 5–13. 10.1007/s10198-008-0096-3PubMedCrossRef Kronborg C, Handberg G, Axelsen F: Health care costs, work productivity and activity impairment in non-malignant chronic pain patients. Eur J Health Econ 2009, 10: 5–13. 10.1007/s10198-008-0096-3PubMedCrossRef
15.
go back to reference Giovannetti ER, Wolff JL, Frick KD, Boult C: Construct validity of the Work Productivity and Activity Impairment questionnaire across informal caregivers of chronically ill older patients. Value Health 2009, 12: 1011–1017. 10.1111/j.1524-4733.2009.00542.xPubMedCentralPubMedCrossRef Giovannetti ER, Wolff JL, Frick KD, Boult C: Construct validity of the Work Productivity and Activity Impairment questionnaire across informal caregivers of chronically ill older patients. Value Health 2009, 12: 1011–1017. 10.1111/j.1524-4733.2009.00542.xPubMedCentralPubMedCrossRef
16.
go back to reference Norman GR, Sloan JA, Wyrwich KW: Interpretation of changes in health-related quality of life: the remarkable universality of half a standard deviation. Med Care 2003, 41: 582–592. 10.1097/00005650-200305000-00004PubMed Norman GR, Sloan JA, Wyrwich KW: Interpretation of changes in health-related quality of life: the remarkable universality of half a standard deviation. Med Care 2003, 41: 582–592. 10.1097/00005650-200305000-00004PubMed
17.
go back to reference Guyatt G, Walter S, Norman G: Measuring change over time: assessing the usefulness of evaluative instruments. J Chronic Dis 1987, 40: 171–178. 10.1016/0021-9681(87)90069-5PubMedCrossRef Guyatt G, Walter S, Norman G: Measuring change over time: assessing the usefulness of evaluative instruments. J Chronic Dis 1987, 40: 171–178. 10.1016/0021-9681(87)90069-5PubMedCrossRef
18.
go back to reference Cohen J: Statistical power analysis for the behavioral sciences. 2nd edition. Hillsdale, NJ: Lawrence Erlbaum Associates; 1988. Cohen J: Statistical power analysis for the behavioral sciences. 2nd edition. Hillsdale, NJ: Lawrence Erlbaum Associates; 1988.
19.
go back to reference Occupational Employment Statistics. May 2007 National Occupational Employment and Wage Estimates. United States. Bureau of Labor Statistics 2007. Occupational Employment Statistics. May 2007 National Occupational Employment and Wage Estimates. United States. Bureau of Labor Statistics 2007.
20.
go back to reference van den Nieuwenhof L, Schermer T, Heins M, Grootens J, Eysink P, Bottema B, et al.: Tracing uncontrolled asthma in family practice using a mailed asthma control questionnaire. Ann Fam Med 2008,6(Suppl 1):S16-S22. 10.1370/afm.776PubMedCentralPubMedCrossRef van den Nieuwenhof L, Schermer T, Heins M, Grootens J, Eysink P, Bottema B, et al.: Tracing uncontrolled asthma in family practice using a mailed asthma control questionnaire. Ann Fam Med 2008,6(Suppl 1):S16-S22. 10.1370/afm.776PubMedCentralPubMedCrossRef
21.
go back to reference Chapman KR, Boulet LP, Rea RM, Franssen E: Suboptimal asthma control: prevalence, detection and consequences in general practice. Eur Respir J 2008, 31: 320–325. 10.1183/09031936.00039707PubMedCrossRef Chapman KR, Boulet LP, Rea RM, Franssen E: Suboptimal asthma control: prevalence, detection and consequences in general practice. Eur Respir J 2008, 31: 320–325. 10.1183/09031936.00039707PubMedCrossRef
22.
go back to reference Bateman ED, Boushey HA, Bousquet J, Busse WW, Clark TJ, Pauwels RA, et al.: Can guideline-defined asthma control be achieved? The Gaining Optimal Asthma ControL study. Am J Respir Crit Care Med 2004, 170: 836–844. 10.1164/rccm.200401-033OCPubMedCrossRef Bateman ED, Boushey HA, Bousquet J, Busse WW, Clark TJ, Pauwels RA, et al.: Can guideline-defined asthma control be achieved? The Gaining Optimal Asthma ControL study. Am J Respir Crit Care Med 2004, 170: 836–844. 10.1164/rccm.200401-033OCPubMedCrossRef
23.
go back to reference Moonie SA, Sterling DA, Figgs L, Castro M: Asthma status and severity affects missed school days. J Sch Health 2006, 76: 18–24. 10.1111/j.1746-1561.2006.00062.xPubMedCrossRef Moonie SA, Sterling DA, Figgs L, Castro M: Asthma status and severity affects missed school days. J Sch Health 2006, 76: 18–24. 10.1111/j.1746-1561.2006.00062.xPubMedCrossRef
24.
go back to reference Everhart RS, Fiese BH: Asthma severity and child quality of life in pediatric asthma: a systematic review. Patient Educ Couns 2009, 75: 162–168. 10.1016/j.pec.2008.10.001PubMedCrossRef Everhart RS, Fiese BH: Asthma severity and child quality of life in pediatric asthma: a systematic review. Patient Educ Couns 2009, 75: 162–168. 10.1016/j.pec.2008.10.001PubMedCrossRef
25.
go back to reference Schmier JK, Manjunath R, Halpern MT, Jones ML, Thompson K, Diette GB: The impact of inadequately controlled asthma in urban children on quality of life and productivity. Ann Allergy Asthma Immunol 2007, 98: 245–251. 10.1016/S1081-1206(10)60713-2PubMedCrossRef Schmier JK, Manjunath R, Halpern MT, Jones ML, Thompson K, Diette GB: The impact of inadequately controlled asthma in urban children on quality of life and productivity. Ann Allergy Asthma Immunol 2007, 98: 245–251. 10.1016/S1081-1206(10)60713-2PubMedCrossRef
26.
go back to reference Williams SA, Wagner S, Kannan H, Bolge SC: The association between asthma control and health care utilization, work productivity loss and health-related quality of life. J Occup Environ Med 2009, 51: 780–785. 10.1097/JOM.0b013e3181abb019PubMedCrossRef Williams SA, Wagner S, Kannan H, Bolge SC: The association between asthma control and health care utilization, work productivity loss and health-related quality of life. J Occup Environ Med 2009, 51: 780–785. 10.1097/JOM.0b013e3181abb019PubMedCrossRef
27.
go back to reference Weisel CP, Weiss SH, Tasslimi A, Alimokhtari S, Belby K: Development of a Web-based questionnaire to collect exposure and symptom data in children and adolescents with asthma. Ann Allergy Asthma Immunol 2008, 100: 112–119. 10.1016/S1081-1206(10)60419-XPubMedCentralPubMedCrossRef Weisel CP, Weiss SH, Tasslimi A, Alimokhtari S, Belby K: Development of a Web-based questionnaire to collect exposure and symptom data in children and adolescents with asthma. Ann Allergy Asthma Immunol 2008, 100: 112–119. 10.1016/S1081-1206(10)60419-XPubMedCentralPubMedCrossRef
28.
go back to reference Harris KM, Schonlau M, Lurie N: Surveying a nationally representative internet-based panel to obtain timely estimates of influenza vaccination rates. Vaccine 2009, 27: 815–818. 10.1016/j.vaccine.2008.11.052PubMedCrossRef Harris KM, Schonlau M, Lurie N: Surveying a nationally representative internet-based panel to obtain timely estimates of influenza vaccination rates. Vaccine 2009, 27: 815–818. 10.1016/j.vaccine.2008.11.052PubMedCrossRef
29.
go back to reference Heeren T, Edwards EM, Dennis JM, Rodkin S, Hingson RW, Rosenbloom DL: A comparison of results from an alcohol survey of a prerecruited Internet panel and the National Epidemiologic Survey on Alcohol and Related Conditions. Alcohol Clin Exp Res 2008, 32: 222–229. 10.1111/j.1530-0277.2007.00571.xPubMedCrossRef Heeren T, Edwards EM, Dennis JM, Rodkin S, Hingson RW, Rosenbloom DL: A comparison of results from an alcohol survey of a prerecruited Internet panel and the National Epidemiologic Survey on Alcohol and Related Conditions. Alcohol Clin Exp Res 2008, 32: 222–229. 10.1111/j.1530-0277.2007.00571.xPubMedCrossRef
30.
go back to reference Hamilton MB: Online survey response rates and times; background and guidance for industry. Ipathia, Inc./SuperSurvey; 2009. Hamilton MB: Online survey response rates and times; background and guidance for industry. Ipathia, Inc./SuperSurvey; 2009.
Metadata
Title
Uncontrolled asthma: assessing quality of life and productivity of children and their caregivers using a cross-sectional Internet-based survey
Authors
Bonnie B Dean
Brian C Calimlim
Patricia Sacco
Daniel Aguilar
Robert Maykut
David Tinkelman
Publication date
01-12-2010
Publisher
BioMed Central
Published in
Health and Quality of Life Outcomes / Issue 1/2010
Electronic ISSN: 1477-7525
DOI
https://doi.org/10.1186/1477-7525-8-96

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