Parent misperception of control in childhood/adolescent asthma: the Room to Breathe survey

Carroll, Will; Wildhaber, Johannes H.; Brand, P. L. P.

doi:10.1183/09031936.00048911

Cited by 87 publications

(91 citation statements)

References 35 publications

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“…There are no previous studies using the ACT in schools in the UK. However, these results are compatible with an international telephone-survey done in 2009 in a different population of children, which found 40% of children (aged 4 to 15 years) with suboptimal asthma control by the C-ACT [9]. To date, two studies have recruited UK schoolchildren with asthma, but neither has assessed asthma control.…”

Section: Discussionsupporting

confidence: 71%

“…Overoptimistic assessment of asthma control and of outcomes is of concern since the 2014 UK National Review of Asthma Deaths [17] reported that deaths in children and young people were associated with poor perception of the risk of adverse outcome. Although parent-reported control was not assessed in the present study, the 'Room to Breathe Survey' [9] suggests that parents' perception of control is even more optimistic than their own child's, since 73% of parents described their child's asthma as mild or intermittent, despite only 40% of children scoring 19 or less on the C-ACT.…”

Section: Discussionmentioning

confidence: 94%

“…A strength of the present study is that, by assessing asthma control in the school environment, we have reduced the potential for students to be influenced by overoptimistic parental expectations of control, as previously reported [9]. Children with asthma who do not have a usual source of care, or who do not routinely visit their physician could also be captured by recruiting through schools.…”

Section: Discussionmentioning

confidence: 97%

“…This international study administered, by telephone, the childhood asthma control test (C-ACT; a 7-item questionnaire validated in children of 4 to 11 years [8]) to families of asthmatic children aged 4 to 15 years. Overall, 40% of the 1284 children surveyed, including 200 from the UK, had either parent-reported (for children aged 4 to 15 years), or child-reported (for children and young people aged 8 to 15 years) suboptimal control by the C-ACT [9].…”

Section: Introductionmentioning

confidence: 99%

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Asthma control in London secondary school children

Harris

Mosler

et al. 2017

Journal of Asthma

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Objective: The asthma control test (ACT) is a validated tool for assessing control in asthmatic children aged 12 years and older. Using the ACT, we sought to assess asthma control and knowledge in London secondary school children. Methods: Secondary schools in London, UK, participated in this study. Children with doctor-diagnosed asthma were invited to complete an online questionnaire that included the ACT and questions about asthma. Suboptimal asthma control was defined as an ACT score of ࣘ 19 out of a maximum score of 25. Data are summarised as median and interquartile range (IQR), and were analysed by either Mann-Whitney test, or chi-square test. A p value of < 0.05 was considered significant. Results: A total of 799 children completed the questionnaire; 689 (86.2%) were included for analysis. Suboptimal asthma control was reported by 49.6% of students. Over a third (42.4%) of students prescribed a short-acting β2-agonist inhaler felt uncomfortable using it at school, and 29.2% (n = 173) reported not using this inhaler when wheezy. 56.4% (n = 220) of those with regular inhaled corticosteroids did not take them as prescribed, and 41.7% did not know what this inhaler was for. Suboptimal control was associated with a greater proportion of students reporting that they were 'somewhat' , 'hardly' or 'not at all' comfortable using inhalers at school (52.7% vs 29.1%, p < 0.01) and outside school (22.8% vs. 14.8%, p < 0.01). Conclusions: Suboptimal asthma control and poor asthma knowledge are common in London schoolchildren.

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Section: Discussionsupporting

confidence: 71%

Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Asthma control in London secondary school children

Harris

Mosler

et al. 2017

Journal of Asthma

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“…There is a separate version for children aged 4-12 years (the C-ACT), which consists of four pictorial items that are scored by the children themselves and three verbal items that are scored by the parents. One should be aware that children tend to report their asthma control to be significantly lower than their parents [19,20]. The ACQ contains six items with a recall window of 1 week; this is supplemented by measurement of FEV1 as a percentage of predicted ("the seventh question") [18].…”

Section: Composite Asthma Control Scoresmentioning

confidence: 99%

Monitoring asthma in childhood: symptoms, exacerbations and quality of life

et al. 2015

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Monitoring asthma in children in clinical practice is primarily performed by reviewing disease activity (daytime and night-time symptoms, use of reliever medication, exacerbations requiring frequent use of reliever medication and urgent visits to the healthcare professional) and the impact of the disease on children's daily activities, including sports and play, in a clinical interview. In such an interview, most task force members also discuss adherence to maintenance therapy and the patients' (and parents') views and beliefs on the goals of treatment and the amount of treatment required to achieve those goals. Composite asthma control and quality of life measures, although potentially useful in research, have limited value in clinical practice because they have a short recall window and do not cover the entire spectrum of asthma control. Telemonitoring of children with asthma cannot replace face-to-face follow-up and monitoring because there is no evidence that it is associated with improved health outcomes. @ERSpublications To monitor asthma control in children interviewing the child and parents is preferred over composite control scores http://ow.ly/JbqnR

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Financial Barriers to Care Among Low-Income Children With Asthma

et al. 2014

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Care Act (ACA) includes subsidies that reduce patient cost sharing for low-income families. Limited information on the effects of cost sharing among children is available to guide these efforts.OBJECTIVE To examine the associations between cost sharing, income, and care seeking and financial stress among children with asthma. DESIGN, SETTING, AND PARTICIPANTSA telephone survey in 2012 about experiences during the prior year within an integrated health care delivery system. Respondents included 769 parents of children aged 4 to 11 years with asthma. Of these, 25.9% of children received public subsidies; 21.7% were commercially insured with household incomes at or below 250% of the federal poverty level (FPL) and 18.2% had higher cost-sharing levels for all services (eg, Ն$75 for emergency department visits). We classified children with asthma based on (1) current receipt of a subsidy (ie, Medicaid or Children's Health Insurance Program) or potential eligibility for ACA low-income cost sharing or premium subsidies in 2014 (ie, income Յ250%, 251%-400%, or >400% of the FPL) and (2) cost-sharing levels for prescription drugs, office visits, and emergency department visits. We examined the frequency of changes in care seeking and financial stress due to asthma care costs across these groups using logistic regression, adjusted for patient/family characteristics. MAIN OUTCOMES AND MEASURESSwitching to cheaper asthma drugs, using less medication than prescribed, delaying/avoiding any office or emergency department visits, and financial stress (eg, cutting back on necessities) because of the costs of asthma care.RESULTS After adjustment, parents at or below 250% of the FPL with lower vs higher cost-sharing levels were less likely to delay or avoid taking their children to a physician's office visit (3.8% vs 31.6%; odds ratio, 0.07 [95% CI, 0.01-0.39]) and the emergency department (1.2% vs 19.4%; 0.05 [0.01-0.25]) because of cost; higher-income parents and those whose children were receiving public subsidies (eg, Medicaid) were also less likely to forego their children's care than parents at or below 250% of the FPL with higher cost-sharing levels. Overall, 15.6% of parents borrowed money or cut back on necessities to pay for their children's asthma care. CONCLUSIONS AND RELEVANCECost-related barriers to care among children with asthma were concentrated among low-income families with higher cost-sharing levels. The ACA's low-income subsidies could reduce these barriers for many families, but millions of dependents for whom employer-sponsored family coverage is unaffordable could remain at risk for cost-related problems because of ACA subsidy eligibility rules.

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Parent misperception of control in childhood/adolescent asthma: the Room to Breathe survey

Abstract: The aim of our study was to determine how often asthma control is achieved in children and adolescents, and how asthma affects parents' and children's daily lives.

Cited by 87 publications

References 35 publications

Asthma control in London secondary school children

Asthma control in London secondary school children

Monitoring asthma in childhood: symptoms, exacerbations and quality of life

Financial Barriers to Care Among Low-Income Children With Asthma

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