PURPOSE OF THE STUDY.
The goal of this study was to evaluate the utility of assessing direction, bother, and risk domains within the Pediatric Asthma Control and Communication Instrument (PACCI), a validated parent-completed questionnaire assessing 5 dimensions of asthma health, as part of guideline-recommended asthma care.
A convenience sample of 317 children diagnosed with asthma (mean age: 8.2 years; 58% boys; 44% African American) was recruited from 2 university-based asthma specialty care clinics.
Cross-sectional data were collected on demographic characteristics, spirometric values (1 center), and results of several parent-completed questionnaires. The Pediatric Asthma Caregiver Quality of Life Questionnaire (PACQLQ) assessed asthma-specific quality of life, and asthma control was measured by using the validated PACCI control domain. Mean asthma PACCI control, PACQLQ, and lung function values were assessed across the domains of direction (asthma improving or worsening), bother, and risk by using analysis of variance. The PACCI was further analyzed for discriminative validity by using linear regression and χ2 analyses.
Measures of asthma control and quality of life decreased as parent-reported PACCI direction moved from “better” to “worse.” Similar results were observed as the PACCI bother domain varied from “not bothered” to “very bothered,” although no associations were found with these domains and lung function. Any reported PACCI risk event was associated with poorer asthma control and PACQLQ scores.
The PACCI is a valid measure of multiple indicators of asthma morbidity, allowing for assessment of asthma control, risk, and 2 measures of quality of life (direction and bother) in 1 questionnaire. Such measures better address the asthma guideline recommendation of the National Heart, Lung, and Blood Institute that patient experiences be assessed directly rather than extrapolated from other clinical measures. Predictive implications and effect on patient care and outcomes have yet to be determined.
This study provides evidence that subjective parent-reported measures correlate well with other known measures of asthma control and quality of life. Given the convenience of using only 1 questionnaire for all measures, the PACCI is a viable approach to ensuring multidimensional asthma care as recommended by current asthma guidelines.
- Copyright © 2014 by the American Academy of Pediatrics