Related Experiment Videos
A potential pitfall in provider assessments of the quality of asthma control
Jill S Halterman1, Kenneth M McConnochie, Kelly M Conn
1Department of Pediatrics, University of Rochester School of Medicine, NY 14642, USA. jill_halterman@urmc.rochester.edu
Insights
Most parents underestimate their child's asthma severity. A general question about asthma control often leads to inaccurate assessments, even with daily symptoms. Pediatricians should inquire about specific symptoms for better management.
Area of Science:
- Pediatric Pulmonology
- Asthma Management
- Child Health Outcomes
Background:
- Pediatricians rely on parental input for asthma control assessment.
- Inaccurate parental reporting of good asthma control can lead to suboptimal management plans.
- A single general question may not accurately capture asthma severity in children.
Purpose of the Study:
- To evaluate if a single, general question about asthma control leads to underestimation of severity by parents.
- To compare parental perception of asthma control with objective measures of symptom severity and medication use.
Main Methods:
- Survey of parents of children aged 3-7 years with mild to severe asthma (NHLBI criteria).
- Data collected via phone survey included demographics, symptom frequency, medication use, and general control assessment.
- Chi-square analyses compared parental assessment with demographic factors and asthma severity indicators.
Main Results:
- 78% of parents reported good asthma control for their children.
- Parental assessment of control did not correlate with demographic characteristics.
- Parents frequently reported good control even for children with daily symptoms or those on daily rescue medication.
Conclusions:
- Parents often underestimate their child's asthma severity, reporting good control globally.
- A general question about asthma control is insufficient and leads to underestimation.
- Pediatricians should ask about specific asthma symptoms to accurately assess severity and guide treatment.
Background:
Pediatricians elicit information about asthma control from parents to help formulate management plans. If parents of children with significant asthma symptoms inappropriately indicate good control, physician recommendations may not be optimal. We examined whether a single general question about asthma control might lead to inaccurate assessment of severity.
Design/Methods:
Children 3-7 years of age who met the National Heart, Lung, and Blood Institute (NHLBI) criteria for mild persistent to severe asthma were identified from 40 urban schools. A phone survey of their parents provided demographic information, symptom frequency, medication use, and general interpretation of their child's asthma control. Chi-square analyses compared the parent's general interpretation of control with demographic characteristics and measures of asthma severity.
Results:
One hundred sixty of 224 eligible children participated in this study. Seventy-eight percent were described as in good asthma control. General assessment of asthma control did not vary by demographic characteristics. Parents were as likely to describe children with daily asthma symptoms in good control as they were to describe children with less frequent symptoms in good control. Parents were less likely to report good control in children using daily rescue medications when compared with children with less frequent medication use (65% vs 82%, P =.03), but the majority of children in both groups was described as having good control.
Conclusions:
Most parents underestimated the severity of their child's asthma and reported good control with their global assessment. Parents frequently reported good control even when the children had daily asthma symptoms. Pediatricians should ask about specific asthma symptoms during patient encounters because a global question about asthma control likely will result in underestimations of asthma severity.