Asthma Exacerbations and Triggers in Children in TENOR: Impact on Quality of Life

• Published in: Pediatrics (Evanston) 2018-12, Vol.142 (Supplement_4), p.S261-S262
• Main Authors: Polk, Brooke I., Dinakar, Chitra
• Format: Article
• Language: English
• Subjects: Asthma; Children; Children & youth; Chronic illnesses; Epidemiology; Patients; Pediatrics; Population studies; Quality of life
• ISSN: 0031-4005; 1098-4275
• DOI: 10.1542/peds.2018-2420FFFF

PURPOSE OF THE STUDY. To assess the impact of asthma triggers and exacerbations on asthma-specific quality of life in children. STUDY POPULATION. A 3-year observational study, The Epidemiology and Natural History of Asthma Outcomes and Treatment Regimens, included a cohort of 438 children aged 6 to 12 years with severe or difficult-to-treat asthma recruited from 283 sites in the United States. METHODS. Patients were seen at 6-month intervals, and data on health care use, asthma exacerbations, and number of recent asthma triggers were obtained. Patients and parents completed the Pediatric Asthma Quality of Life Questionnaire (PAQLQ) and the Asthma Therapy Assessment Questionnaire. Multivariable linear regression was used to model the PAQLQ score as a function of common asthma triggers. RESULTS. Greater asthma exacerbation severity and number were associated with lower PAQLQ scores (P < .001), indicating poorer quality of life. PAQLQ was significantly lower in patients with more baseline triggers, and greater trigger number was associated with both severity and number of asthma exacerbations. CONCLUSIONS. The number of baseline asthma triggers affects quality of life, exacerbation severity, and frequency of exacerbations in children aged 6 to 12 with severe or difficult-to-control asthma. REVIEWER COMMENTS. Asthma is the most common childhood chronic disease in the United States, accounting for many missed school days and a significant social and economic burden for patients and families. The authors of this study emphasize the need to identify asthma triggers and to counsel patients on trigger avoidance as a way to reduce the number and severity of asthma exacerbations in children with severe and difficult-to-treat asthma. Addressing the psychosocial aspects of asthma via identification of baseline disease characteristics that negatively affect asthma-related quality of life can help lead to a patient-centered care approach.