Prevalence and predictors of uncontrolled asthma in children referred for asthma and other atopic diseases
Kansen, H. M.; Le, T. M.; Uiterwaal, C. S.P.M.; van Ewijk, B. E.; Balemans, W. A.F.; Gorissen, D. M.W.; de Vries, E.; van Velzen, M. F.; Slabbers, G. H.P.R.; Meijer, Y.; Knulst, A. C.; van der Ent, C. K.; van Erp, F. C.
(2020) Journal of Asthma and Allergy, volume 13, pp. 67 - 75
(Article)
Abstract
Background: Uncontrolled asthma in children is still highly prevalent despite the availability of effective asthma treatment. We investigated 1) the prevalence of uncontrolled asthma among children referred for asthma and referred for atopic diseases other than asthma (ie food allergy, allergic rhinitis or atopic dermatitis) to secondary care; and 2)
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the predictors associated with uncontrolled asthma. Methods: All children (4 to 18 years) referred for asthma or atopic diseases other than asthma to 8 secondary care centers in The Netherlands were invited to an electronic portal (EP). The EP is a web-based application with several validated questionnaires including the ISAAC questionnaires and the Asthma Control Test (ACT). Children were eligible for inclusion in this study when their parents reported in the EP that their child had asthma diagnosed by a physician. The ACT was used to assess asthma control. Multiple predictors of asthma control (patient, asthma and atopic characteristics) were evaluated by univariable and multivariable logistic regression analyses. Results: We included 408 children: 259 children (63%) with asthma referred for asthma and 149 children (37%) with asthma referred for atopic diseases other than asthma. Thirty-nine percent of all children had uncontrolled asthma: 47% of the children referred for asthma and 26% of the children referred for atopic diseases other than asthma. Predictors associated with uncontrolled asthma were a family history of asthma (odds ratio [OR] 2.08; 95% confidence interval [95% CI] 1.34 to 3.24), and recurrent upper and lower respiratory tract infections in the past year (OR 2.40; 95% CI 1.52 to 3.81 and OR 2.00; 95% CI 1.25 to 3.23, respectively). Conclusion: Uncontrolled asthma is highly prevalent in children with asthma referred to secondary care, even if children are primarily referred for atopic diseases other than asthma. Thus, attention should be paid to asthma control in this population.
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Keywords: Asthma, Asthma control, Atopic diseases, Prognosis, Respiratory tract infections, Immunology and Allergy, Pulmonary and Respiratory Medicine, Journal Article
Publisher: Dove Medical Press Ltd.
Note: Funding Information: The authors would like to thank the members of the Expert Network P.F. Eskes (Department of Pediatrics, Meander Medical Center, Amersfoort, the Netherlands), R. van Gent (Department of Pediatrics, Máxima Medical Center, Veldhoven, the Netherlands; R. van Gent passed away on May 28, 2014) and A.G. Ketel (Department of Pediatrics, Spaarne Hospital, Hoofddorp, the Netherlands). Furthermore, the authors would like to thank P.M. J. Welsing (Department of Dermatology, University Medical Center Utrecht, Utrecht, the Netherlands) for his statistical advice and L.M. Verhagen (Department of Pediatrics, University Medical Center Utrecht, Wilhelmina Children’s Hospital, Utrecht, the Netherlands) for her help to define recurrent respiratory tract infections in children. An abstract of this paper was presented at the European Academy of Allergy and Clinical Immunology Congress, 2019, as a poster presentation with interim findings. The poster’s abstract was published in “Abstracts LB PDS” in Allergy (https://onli nelibrary.wiley.com/toc/13989995/2019/74/S106). This study was supported by the Stichting Astma Bestrijding Nederland. The electronic portal was supported by an unrestricted grant of GlaxoSmithKline and ALK-Abelló. Funding Information: This study was supported by the Stichting Astma Bestrijding Nederland. The electronic portal was supported by an unrestricted grant of GlaxoSmithKline and ALK-Abelló. Publisher Copyright: © 2020 Kansen et al.
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