PURPOSE: To compare absenteeism between controlled and uncontrolled asthma patients among children, caregivers of children, and adults.
METHODS: Patients enrolled in the National Jewish Medical and Research Center Disease Management program for asthma from 1996 to 2006 were classified as having uncontrolled asthma based on the following criteria upon program entry: (1) on a controller medication and (2) satisfying at least one of the following: (i) hospitalization or ER visit within the last 6 months; (ii) symptoms ≥3 nights/month; or (iii) daily or continual asthma symptoms. All other patients were classified as having controlled asthma. The number of school or work days missed was collected for the 6 months prior to enrollment. Counts were compared using the Wilcoxon-Mann-Whitney test. Zero-Inflated Poisson regression modeling, which takes into account the skewed distribution of the data, was also conducted.
RESULTS: Of the 40,617 patients enrolled in the program, 13,499 patients had absenteeism data on initial assessment and were classified as controlled (1,990 children; 1,689 pediatric caregivers; 5,386 adults) or uncontrolled (1,038 children; 846 pediatric caregivers; 5,084 adults). On average, controlled pediatric patients, pediatric patient caregivers, and adult patients missed 2.60 school days, 0.67 work days, and 1.51 work days, respectively. Uncontrolled pediatric patients, pediatric patient caregivers, and adult patients missed 6.39 school days, 1.93 work days, and 4.65 work days, respectively. Thus, uncontrolled asthma groups experienced more absenteeism than controlled groups (P<0.001 for all three comparisons). Uncontrolled children missed 3.79 (145%) more school days, caregivers missed 1.26 (188%) more work days, and adults missed 3.14 (208%) more work days than their controlled counterparts. Fitting the data to a Zero-Inflated Poisson regression model yielded similar results.
CONCLUSION: Compared with controlled asthma, uncontrolled asthma was associated with 2 to 3 times as many school and work days missed due to asthma among pediatric patients, caregivers of pediatric patients, and adult patients.
CLINICAL IMPLICATIONS: Adequately treating and controlling asthma symptoms can potentially reduce absenteeism among pediatric and adult patients with asthma and caregivers of pediatric patients.
DISCLOSURE: Lawrence McDermott, No Product/Research Disclosure Information; Employee Rezaul Khandker, Songkai Yan, Vincent Ciuryla, and Lawrence McDermott are employees of Wyeth Research; Consultant fee, speaker bureau, advisory committee, etc. Brian Calimlim and Bonnie Dean are employed by Cerner LifeSciences, which provides consulting services to Wyeth Research.