The Influence of Variation in Type and Pattern of Symptoms on Assessment in Pediatric Asthma
- 1 August 2006
- journal article
- Published by American Academy of Pediatrics (AAP) in Pediatrics
- Vol. 118 (2), 619-625
- https://doi.org/10.1542/peds.2005-2963
Abstract
OBJECTIVE. We conducted a national, population-based survey to examine the asthma-related health burden of US children.METHODS. A telephone-based survey was conducted in 2004 of children 4 to 18 years of age with current asthma in the United States. In 41433 households screened, 1089 children reported current asthma; 801 interviews were completed by parents of children aged 4 to 15 years and by children themselves aged 16 to 18 years. The survey included questions about symptoms, perceived level of control, activity limitations, health care use, medicines, disease management, and knowledge. Global asthma symptom burden, derived from the National Asthma Education and Prevention Program guidelines, was composed of 3 components: short-term symptom burden (4-week recall), long-term symptom burden (past year), and functional impact (activity limitation).RESULTS. The majority of children were classified with mild intermittent disease on the basis of recent daytime symptoms alone (80%); yet, when report of nighttime symptoms was included, the proportion of children classified as having mild intermittent symptoms decreased (74%). When asthma burden was assessed on the basis of the global symptom burden construct, only a minority (13%) of individuals was classified as having an asthma symptom burden consistent with mild intermittent disease; the majority (62%) was classified as having moderate/severe disease. In addition, the impact of asthma on the daily activities is substantial; avoiding exertion (47%) and staying inside (34%) are common approaches to improve control of asthma symptoms.CONCLUSIONS. The goals of therapy for asthma, based on the National Asthma Education and Prevention Program guidelines, have not been achieved for the majority of children. In addition, parents and children overestimate the child's asthma control and commonly restrict activities to control asthma symptoms. Deficiencies in the control of asthma may be related to the underestimation of the burden of disease.Keywords
This publication has 11 references indexed in Scilit:
- Patterns of asthma control: A 3-year analysis of patient claimsJournal of Allergy and Clinical Immunology, 2005
- Classifying Asthma Severity in ChildrenAmerican Journal of Respiratory and Critical Care Medicine, 2004
- Relationship between quality of life and clinical status in asthma: a factor analysisEuropean Respiratory Journal, 2004
- Asthma variability in patients previously treated with β2-agonists aloneJournal of Allergy and Clinical Immunology, 2003
- The Burden of Asthma in the United StatesAmerican Journal of Respiratory and Critical Care Medicine, 2002
- Impact of Inhaled Antiinflammatory Therapy on Hospitalization and Emergency Department Visits for Children With AsthmaPediatrics, 2001
- Clinical management of asthma in 1999: the Asthma Insights and Reality in Europe (AIRE) studyEuropean Respiratory Journal, 2000
- Long-Term Effects of Budesonide or Nedocromil in Children with AsthmaNew England Journal of Medicine, 2000
- Preventable factors in hospital admissions for asthmaArchives of Disease in Childhood, 1998
- Potentially avoidable hospitalizations: inequalities in rates between US socioeconomic groups.American Journal of Public Health, 1997