Assessing health outcomes, quality of life, and healthcare use among school-age children with asthma

• Published in: The Journal of asthma 2019-01, Vol.56 (1), p.42-49
• Main Authors: Lozier, Matthew J., Zahran, Hatice S., Bailey, Cathy M.
• Format: Article
• Language: English
• Subjects: Absenteeism; activity limitation; Adolescent; Anti-Asthmatic Agents - therapeutic use; Asthma - drug therapy; Asthma - epidemiology; Asthma - physiopathology; Asthma - psychology; asthma attacks; Behavioral Risk Factor Surveillance System; Bronchodilator Agents - therapeutic use; Child; Child, Preschool; ED visit; Emergency Service, Hospital - statistics & numerical data; Female; Health Resources - statistics & numerical data; hospitalization; Hospitalization - statistics & numerical data; Humans; Logistic Models; long-term control medication; Male; missed school days; Patient Acceptance of Health Care - statistics & numerical data; Quality of Life; Severity of Illness Index; Socioeconomic Factors; Uncontrolled asthma; United States - epidemiology
• ISSN: 0277-0903; 1532-4303
• DOI: 10.1080/02770903.2018.1426767

Objective: Asthma affects six million children in the United States. Most people can control their asthma symptoms with effective care, management, and appropriate medical treatment. Information on the relationship between asthma control and quality of life indicators and health care use among school-age children is limited. Methods: Using the 2006-2010 combined Behavior Risk Factor Surveillance System Asthma Call-back Survey child data, we examined asthma control and asthma attack status among school-age (aged 5-17 years) children with asthma from 35 states and the District of Columbia. Multivariable logistic regression models were used to assess if having uncontrolled asthma and having ≥1 asthma attacks affect quality of life (activity limitation and missed school days) and healthcare use (emergency department [ED] visits and hospitalizations). Results: About one-third (36.5%) of the 8,484 respondents with current asthma had uncontrolled asthma and 56.8% reported ≥1 asthma attack in the past year. Having uncontrolled asthma and having ≥1 asthma attack were significantly associated with activity limitation (aPR = 1.43 and 1.74, respectively), missed school (1.45 and 1.68), ED visits (2.05 and 4.78), and hospitalizations (2.38 and 3.64). Long-term control (LTC) medication use was higher among respondents with uncontrolled asthma (61.3%) than respondents with well-controlled asthma (33.5%). Conclusions: Having uncontrolled asthma is associated with reduced quality of life and increased health care use. However, only 61.3% of respondents with uncontrolled asthma use LTC medications. Increasing use of LTC medications among children with uncontrolled asthma could help improve quality of life and reduce health care use.