Kazuki Sato1, Yasunori Sato2, Mizuho Nagao3, Naoki Shimojo4, Shigemi Yoshihara5, Yuichi Adachi6, Makoto Kameda7, Akihiko Terada8, Takao Fujisawa3. 1. Department of Pediatrics, Shimoshizu National Hospital, Yotsukaido, Japan. 2. Clinical Research Center, Chiba University, Chiba, Japan. 3. Allergy Center, Mie National Hospital, Tsu, Japan. 4. Department of Pediatrics, University of Chiba Graduate School of Medicine, Chiba, Japan. 5. Department of Pediatrics, Dokkyo Medical University, Utsunomiya, Japan. 6. Department of Pediatrics, Toyama University Graduate School of Medicine, Toyama, Japan. 7. Department of Pediatrics, Osaka Prefectural Medical Center for Respiratory and Allergic Diseases, Habikino, Japan. 8. Terada Kids' Allergy and Asthma Clinic, Nagoya, Japan.
Abstract
BACKGROUND: Several patient-/caregiver-completed questionnaires have been utilized for the assessment of asthma control. However, due to the diversity in medical/social circumstances, they may not be optimal for use in all countries. The Japanese pediatric asthma guideline (JPGL) aims at higher levels of control compared with other international guidelines, based on a strong social demand for best care. We developed a new control test to help meet that demand. METHODS: A 34-item working questionnaire was developed based on input from pediatric asthma specialists and the caregivers of preschool children with asthma. The questionnaire was administered to caregivers of 565 patients aged <6 years who had physician-diagnosed asthma or β2-agonist-responsive recurrent wheeze. Then, 6 questions for assessing JPGL-defined control levels were selected from the 34 questions by stepwise logistic regression methods using randomly selected questionnaires completed by two-thirds of the caregivers. We named that set of questions the Best Asthma Control Test for Preschoolers (Best ACT-P). Validation of Best ACT-P was performed using the remaining completed questionnaires. RESULTS: The 6 questions asked about the frequency/severity of cold-induced wheeze, nighttime awakening, exercise-induced symptoms, and disruption of family life due to asthma in the past 4 weeks and hospitalization in the past 12 months. The 6-item logistic model showed good statistical fit, and the scores for the physicians' ratings of the asthma control differed significantly in the hypothetical direction. CONCLUSIONS: Best ACT-P is a valid caregiver-completed questionnaire of asthma control in preschoolers in whom total control needs to be achieved.
BACKGROUND: Several patient-/caregiver-completed questionnaires have been utilized for the assessment of asthma control. However, due to the diversity in medical/social circumstances, they may not be optimal for use in all countries. The Japanese pediatric asthma guideline (JPGL) aims at higher levels of control compared with other international guidelines, based on a strong social demand for best care. We developed a new control test to help meet that demand. METHODS: A 34-item working questionnaire was developed based on input from pediatric asthma specialists and the caregivers of preschool children with asthma. The questionnaire was administered to caregivers of 565 patients aged <6 years who had physician-diagnosed asthma or β2-agonist-responsive recurrent wheeze. Then, 6 questions for assessing JPGL-defined control levels were selected from the 34 questions by stepwise logistic regression methods using randomly selected questionnaires completed by two-thirds of the caregivers. We named that set of questions the Best Asthma Control Test for Preschoolers (Best ACT-P). Validation of Best ACT-P was performed using the remaining completed questionnaires. RESULTS: The 6 questions asked about the frequency/severity of cold-induced wheeze, nighttime awakening, exercise-induced symptoms, and disruption of family life due to asthma in the past 4 weeks and hospitalization in the past 12 months. The 6-item logistic model showed good statistical fit, and the scores for the physicians' ratings of the asthma control differed significantly in the hypothetical direction. CONCLUSIONS: Best ACT-P is a valid caregiver-completed questionnaire of asthma control in preschoolers in whom total control needs to be achieved.
Authors: Marta Sacchetti; Ilaria Baiardini; Loredana Chini; Viviana Moschese; Alice Bruscolini; Alessandro Lambiase Journal: Pediatric Health Med Ther Date: 2017-09-21