Pediatrics: Pediatric Pulmonary |

Impact of Following Asthma Guidelines on Quality of Life of Families With Asthmatic Children: Long-term Follow-up FREE TO VIEW

Shahid Sheikh, MD; Judy Pitts, APN; Nancy Ryan-Wenger, PhD; David Stukus, MD; Kavitha Kotha, MD; Karen McCoy, MD
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Ohio State University/Nationwide Children's Hospital, Columbus, OH

Copyright 2016, American College of Chest Physicians. All Rights Reserved.

Chest. 2016;150(4_S):960A. doi:10.1016/j.chest.2016.08.1063
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SESSION TITLE: Pediatric Pulmonary

SESSION TYPE: Original Investigation Slide

PRESENTED ON: Tuesday, October 25, 2016 at 02:45 PM - 04:15 PM

PURPOSE: Asthma prevalence is on the rise worldwide and adherence to asthma care guidelines is less than adequate. Measuring quality of life in families is a useful tool in monitoring asthma in children. It seems obvious that impaired quality of life in parents as a result of their child’s asthma affects all aspects of family life Aim: To document improvement, if any, in quality of life in families with asthmatic children by managing their asthma as per NAEPP (EPR-3) guidelines. Objectives were also to document if such improvement correlates with asthma symptom control and could be sustained over time. Another objective of this study was to observe if there is any difference in changes in parents QOL over time when children are managed by a medical doctor (MD) compared to Advanced Practice Nurse (APN).

METHODS: This was a 4 year prospective cohort study. After IRB approval, children enrolled in our pediatric asthma center since 2011 (n = 817), were provided asthma care as per NAEPP guidelines. A validated pediatric quality of life survey (PACQLQ) was used to evaluate the impact of asthma on families during the past week. Families completed the survey at each visit and results were compared over time. Children and caregivers who were seen in clinic at enrollment, and after every 3-6 months were included in this study. At each visit, the parents completed the Pediatric Asthma Caregiver’s Quality of Life Questionnaire (PACQLQ).

RESULTS: The sample included 143 children, ages 7-17 years (mean = 10.6 ±2.9). Male to female ratio was 56.6%:43.4%. The majority of children were Caucasians (n=101, 70.6%) and 35 (24.5%) children were African-Americans. Patients were either followed by physicians (n=65, 45.5%) or nurse practitioners (n=78, 54.5%). The mean total PACQLQ score at the first visit was 62 ±21.2 which improved at the 3 month follow-up visit to 79.5 ±13.2 (p<0.001).. Scores increased again between the 6 month to 9 month visit (79.7 ±10.2 to 86.5 ±8.3, p<.001) and this improvement was sustained over the 4 year period (p<0.001 compared to baseline). Both PACQLQ emotional and activity domains significantly improved at the 3 month follow-up and improvement was sustained over four years. Increasing PACQLQ total emotional and activity scores were associated with ACT scores and days per month of albuterol use, wheezing, cough, and exercise limitations between the first visit and 3 month visit (p<.05), and at several time points over the four-year period. Improvement in PACQLQ total, emotion and activity sub-groups and change in ACT scores and number of days of albuterol use and asthma-related symptoms were not affected by type of health care provider.

CONCLUSIONS: Following NAEPP guidelines significantly improved the quality of life of families with asthmatic children and decreased the use of albuterol and asthma-related symptoms over the four-year follow-up period. Improvement was not dependent on type of health care provider.

CLINICAL IMPLICATIONS: Following asthma guidelines do improve QoL in familkies of asthmatic children independent of type of health care providers.

DISCLOSURE: The following authors have nothing to disclose: Shahid Sheikh, Judy Pitts, Nancy Ryan-Wenger, David Stukus, Kavitha Kotha, Karen McCoy

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