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Factors Associated with Asthma Control in Children: Findings from a National Web-Based Survey
Abstracts AB175
J ALLERGY CLIN IMMUNOL VOLUME 135, NUMBER 2
The Predictors for Asthma Control By Stepwise Treatment in Elderly Asthma Patients Ga Young Ban, MD1, Young Min Ye, MD1, Youn hwan Lee2, So Hee Lee1, Jeong-Eun Kim, MD3, Young-Hee Nam, MD4, Soo-Keol Lee, MD5, Joo-Hee Kim, MD6, Jung Ki-Suck7, Sang-Ha Kim, MD, PhD8, Hae-Sim Park9; 1Department of Allergy & Clinical Immunology, Ajou University School of Medicine, Suwon, South Korea, 2Department of Preventive Medicine & Public Health, Ajou University School of Medicine, South Korea, 3Samsung Changwon Hospital, Changwon, South Korea, 4Department of Internal Medicine, College of Medicine, Dong-A University, Busan, South Korea, 5Dong-A University College of Medicine, Pusan, South Korea, 6Hallym University School of Medicine, Anyang, 7 Hallym University school of medicine, South Korea, 8Yonsei University Wonju College of Medicine, Wonju, South Korea, 9Ajou University School of Medicine. RATIONALE: The geriatric population is increasing and asthma severity increases with age. METHODS: We determined the predictors for asthma control and exacerbation in elderly Korean patients with asthma. In addition, we investigated the factors that affect asthma-specific quality of life (A-QOL). This is a prospective, multi-center real-life study for 6 months with _ stepwise pharmacologic treatment. A total of 296 asthmatic patients aged > 60 were recruited from five University Centers in Korea. Improvedasthma-control group was defined if patients maintained well controlled status or improved control status for 6 months; the remaining patients were defined as not-improved-asthma-control group. RESULTS: Smaller number of medications for co-morbidities and higher physical functioning (PF) scale were significant predictors for the improved asthma control group (OR 5 0.863, P 5 0.004; OR 5 1.028, _19 at baseline P 5 0.018, respectively). Asthma control test (ACT) score < was a significant predictor of asthma exacerbation at 6 months (OR 5 3.938, P 5 0.048). Asthma duration (F 5 5.656, P50.018), ACT (F 5 12.237, P50.001) at baseline and the presence of asthma exacerbation (F 5 5.565, P50.019) during the 6 months of treatment were significant determinants for the changes of A-QOL. CONCLUSIONS: The number of medications for co-morbidities and performance status determined by PF scale as well as ACT are important parameters for assessing asthma control in elderly asthma patients.
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Factors Associated with Asthma Control in Children: Findings from a National Web-Based Survey Mari Sasaki, MD1, Koichi Yoshida, MD1, Yuichi Adachi, MD, PhD2, Mayumi Furukawa, MD1, Toshiko Itazawa, MD, PhD2, Hiroshi Odajima, MD, PhD3, Hirohisa Saito, MD, PhD4, Akira Akasawa, MD, PhD1; 1Division of Allergy, Tokyo Metropolitan Children’s Medical Center, Tokyo, Japan, 2Department of Pediatrics, University of Toyama, Toyama, Japan, 3Fukuoka National Hospital, Fukuoka, Japan, 4Department of Allergy and Immunology, National Research Institute for Child Health and Development, Tokyo, Japan. RATIONALE: Although achieving and maintaining control of asthma is considered to be the goal of asthma treatment, determinants of asthma control are not fully understood. Our aim was to assess factors associated with asthma control among pediatric patients in the general population. METHODS: In June 2012, a web-based survey was conducted to identify Japanese children aged 6 to 11 years who currently have asthma and evaluate control of their disease using the Childhood Asthma Control Test (C-ACT). Associations were evaluated among uncontrolled asthma (CACT score <20) between environmental factors, demographics and comorbid allergic diseases. RESULTS: Among the 3,066 children with current asthma, 447 (14.6%) had uncontrolled asthma. Multivariable analysis identified factors such as low birth weight, obesity, and pet ownership before birth to be associated with uncontrolled disease {adjusted OR [95%CI]: 1.65[1.25-2.18], 1.44 [1.05-1.99], and 1.68[1.24-2.29], respectively}. Comorbid allergic diseases, especially rhinitis were a significant risk of uncontrolled asthma {adjusted OR53.88[95%CI52.50-6.00] for severe rhinitis}. The severity
of rhinitis symptoms was inversely correlated with the C-ACT score (p<0.001). CONCLUSIONS: A population-based web survey showed an association between several factors and the control of pediatric asthma. The assessment of these factors may help identify the children at risk with uncontrolled asthma.
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Asthma Control Based on ACT Score in a Pediatric Population Divya Jayaraman, MD, Todd David Green, MD, FAAAAI; Children’s Hospital of Pittsburgh, UPMC, Pittsburgh, PA. RATIONALE: The Asthma Control Test (ACT) is a validated survey to assess clinical control of asthma. We hypothesized that a majority of patients followed in our clinic were well-controlled and that there would be some seasonal variation to this control. METHODS: A retrospective chart review was performed on pediatric return visit patients (ages 4-20) seen in the allergy/immunology clinic at Children’s Hospital of Pittsburgh from January 2012-June 2014 with the diagnosis of asthma based on ICD-9 coding. An asthma control test was administered at the time of the visit, and scores were recorded in the chart. A score of 20 or higher indicates well-controlled asthma. A Fischer exact test was used given sample size to determine seasonal variation and statistical significance. Rates of comorbidities, including allergic rhinitis (AR), atopic dermatitis (AD), and food allergy (FA), were also measured. RESULTS: Of 135 asthmatic patients reviewed to date, 82 (61%) had a documented ACT score. 45 (55%) of patients with ACT scores documented demonstrated well-controlled asthma. There was no statistically significant difference in asthma control with seasonal variation. 105 (77%) of the patients with asthma had associated allergic rhinitis, 25 (19%) had a current diagnosis of eczema, and 51 (38%) had associated food allergies. CONCLUSIONS: Using ACT score as the measure, asthma is wellcontrolled in 55% of return visit patients at the Children’s Hospital of Pittsburgh allergy/immunology clinic. There was no significant seasonal variation of asthma control. AR continues to be a common comorbidity in patients with asthma.
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J ALLERGY CLIN IMMUNOL VOLUME 135, NUMBER 2
The Predictors for Asthma Control By Stepwise Treatment in Elderly Asthma Patients Ga Young Ban, MD1, Young Min Ye, MD1, Youn hwan Lee2, So Hee Lee1, Jeong-Eun Kim, MD3, Young-Hee Nam, MD4, Soo-Keol Lee, MD5, Joo-Hee Kim, MD6, Jung Ki-Suck7, Sang-Ha Kim, MD, PhD8, Hae-Sim Park9; 1Department of Allergy & Clinical Immunology, Ajou University School of Medicine, Suwon, South Korea, 2Department of Preventive Medicine & Public Health, Ajou University School of Medicine, South Korea, 3Samsung Changwon Hospital, Changwon, South Korea, 4Department of Internal Medicine, College of Medicine, Dong-A University, Busan, South Korea, 5Dong-A University College of Medicine, Pusan, South Korea, 6Hallym University School of Medicine, Anyang, 7 Hallym University school of medicine, South Korea, 8Yonsei University Wonju College of Medicine, Wonju, South Korea, 9Ajou University School of Medicine. RATIONALE: The geriatric population is increasing and asthma severity increases with age. METHODS: We determined the predictors for asthma control and exacerbation in elderly Korean patients with asthma. In addition, we investigated the factors that affect asthma-specific quality of life (A-QOL). This is a prospective, multi-center real-life study for 6 months with _ stepwise pharmacologic treatment. A total of 296 asthmatic patients aged > 60 were recruited from five University Centers in Korea. Improvedasthma-control group was defined if patients maintained well controlled status or improved control status for 6 months; the remaining patients were defined as not-improved-asthma-control group. RESULTS: Smaller number of medications for co-morbidities and higher physical functioning (PF) scale were significant predictors for the improved asthma control group (OR 5 0.863, P 5 0.004; OR 5 1.028, _19 at baseline P 5 0.018, respectively). Asthma control test (ACT) score < was a significant predictor of asthma exacerbation at 6 months (OR 5 3.938, P 5 0.048). Asthma duration (F 5 5.656, P50.018), ACT (F 5 12.237, P50.001) at baseline and the presence of asthma exacerbation (F 5 5.565, P50.019) during the 6 months of treatment were significant determinants for the changes of A-QOL. CONCLUSIONS: The number of medications for co-morbidities and performance status determined by PF scale as well as ACT are important parameters for assessing asthma control in elderly asthma patients.
566
Factors Associated with Asthma Control in Children: Findings from a National Web-Based Survey Mari Sasaki, MD1, Koichi Yoshida, MD1, Yuichi Adachi, MD, PhD2, Mayumi Furukawa, MD1, Toshiko Itazawa, MD, PhD2, Hiroshi Odajima, MD, PhD3, Hirohisa Saito, MD, PhD4, Akira Akasawa, MD, PhD1; 1Division of Allergy, Tokyo Metropolitan Children’s Medical Center, Tokyo, Japan, 2Department of Pediatrics, University of Toyama, Toyama, Japan, 3Fukuoka National Hospital, Fukuoka, Japan, 4Department of Allergy and Immunology, National Research Institute for Child Health and Development, Tokyo, Japan. RATIONALE: Although achieving and maintaining control of asthma is considered to be the goal of asthma treatment, determinants of asthma control are not fully understood. Our aim was to assess factors associated with asthma control among pediatric patients in the general population. METHODS: In June 2012, a web-based survey was conducted to identify Japanese children aged 6 to 11 years who currently have asthma and evaluate control of their disease using the Childhood Asthma Control Test (C-ACT). Associations were evaluated among uncontrolled asthma (CACT score <20) between environmental factors, demographics and comorbid allergic diseases. RESULTS: Among the 3,066 children with current asthma, 447 (14.6%) had uncontrolled asthma. Multivariable analysis identified factors such as low birth weight, obesity, and pet ownership before birth to be associated with uncontrolled disease {adjusted OR [95%CI]: 1.65[1.25-2.18], 1.44 [1.05-1.99], and 1.68[1.24-2.29], respectively}. Comorbid allergic diseases, especially rhinitis were a significant risk of uncontrolled asthma {adjusted OR53.88[95%CI52.50-6.00] for severe rhinitis}. The severity
of rhinitis symptoms was inversely correlated with the C-ACT score (p<0.001). CONCLUSIONS: A population-based web survey showed an association between several factors and the control of pediatric asthma. The assessment of these factors may help identify the children at risk with uncontrolled asthma.
567
Asthma Control Based on ACT Score in a Pediatric Population Divya Jayaraman, MD, Todd David Green, MD, FAAAAI; Children’s Hospital of Pittsburgh, UPMC, Pittsburgh, PA. RATIONALE: The Asthma Control Test (ACT) is a validated survey to assess clinical control of asthma. We hypothesized that a majority of patients followed in our clinic were well-controlled and that there would be some seasonal variation to this control. METHODS: A retrospective chart review was performed on pediatric return visit patients (ages 4-20) seen in the allergy/immunology clinic at Children’s Hospital of Pittsburgh from January 2012-June 2014 with the diagnosis of asthma based on ICD-9 coding. An asthma control test was administered at the time of the visit, and scores were recorded in the chart. A score of 20 or higher indicates well-controlled asthma. A Fischer exact test was used given sample size to determine seasonal variation and statistical significance. Rates of comorbidities, including allergic rhinitis (AR), atopic dermatitis (AD), and food allergy (FA), were also measured. RESULTS: Of 135 asthmatic patients reviewed to date, 82 (61%) had a documented ACT score. 45 (55%) of patients with ACT scores documented demonstrated well-controlled asthma. There was no statistically significant difference in asthma control with seasonal variation. 105 (77%) of the patients with asthma had associated allergic rhinitis, 25 (19%) had a current diagnosis of eczema, and 51 (38%) had associated food allergies. CONCLUSIONS: Using ACT score as the measure, asthma is wellcontrolled in 55% of return visit patients at the Children’s Hospital of Pittsburgh allergy/immunology clinic. There was no significant seasonal variation of asthma control. AR continues to be a common comorbidity in patients with asthma.
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