Health Related Quality of Life in Children and Caregivers with Controlled versus Uncontrolled Asthma

Excerpt

To the Editor: Children with asthma and their caregivers may have considerable disease morbidity. We compared health related quality of life (HRQL) in children with asthma who have controlled vs. uncontrolled asthma. Secondary outcome measure was HRQL in their caregivers using Indian performa at a tertiary care hospital. After obtaining ethical clearance and informed consent in a cross-sectional study, 50 children with controlled asthma and 50 children with uncontrolled asthma between age group 7–17 y were included. Children with mental sub-normality or any other chronic illness were excluded. Validated questionnaire (Asthma Control Test; ACT and Childhood ACT) were used to define control of asthma and scores of ≤19 indicated an inadequately controlled asthma [1]. A validated HRQL measuring questionnaire with a total of 31 questions was used [2]. A separate questionnaire of 13 questions was given to the caregiver [3]. The children in different age strata in Group A (7 to 12 y: 56%; 12 to 17 y: 44%) and Group B (both strata 50% each) were comparable. The sex distribution of children in both groups was also comparable (Group A – males: 70%, females: 30%; Group B – males: 72%; females: 28%). Total HRQL and individual scores in environmental stimuli and physical domain and symptom score were significantly better in children with controlled asthma as compared to children with uncontrolled asthma (P < 0.001) (Table 1). However scores in emotional domain were comparable in both groups (P 0.77). The caregivers of children with controlled asthma also had statistically significant better scores as compared to caregivers of children with uncontrolled group (P 0.001). Hence, improvement in quality of life is related to disease control [2, 4, 5]. Due to incomplete understanding, ignorance and anxiety regarding the disease and medication etc. by the child, insignificant emotion improvement in children with disease control may occur [2, 4, 5]. The significant difference in environmental stimuli domain implies environmental pollution may affect quality of life in children with asthma. Compared to previous reports we used an Indian questionnaire (culturally and socially acceptable), which was simple and quick, more extensive, with responses directly from children as compared to proxy reports by caregivers in previous reports [2, 4, 5]. We conclude significantly better quality of life in children with controlled asthma and their caregivers as compared to children with uncontrolled asthma. Psychological support, counseling and education in children may improve emotional health and overall well-being. …