symptom variability in children with persistent asthma*1a survey of child caregivers

1012 Symptom Variability in Children With Persistent Asthma: A Survey of Child Caregivers K. R. Murphy 1 , P. Marcus 2 , A. Rahman 3 , C. O’Brien 3 ; 1 Midwest Chil- dren’s Chest Physicians, Omaha, NE, 2 New York College of Osteopathic Medicine, Old Westbury, NY, 3 AstraZeneca, LP, Wilmington, DE. RATIONALE: Patients with asthma may experience periods of increase or decrease of symptoms, which may require an increase (adjusting upward) or decrease (adjusting downward) of controller therapy. This survey questioned caregivers of children with caregiver-identified mild, moderate, and severe persistent asthma to assess the extent of variability of disease symptoms in a pediatric population. METHODS: 23,888 prospective participants were selected from a US database of almost 200,000 patients with asthma and invited to complete an Internet-based survey conducted between September 19 and October 16, 2002. Respondents were eligible to participate if they were caring for a child 6 to 18 years of age identified as having persistent asthma for at least 1 year. RESULTS: Completed questionnaires were obtained from caregivers of children identified as having mild (n=200), moderate (n=192), and severe (n=99) persistent asthma based on symptom frequency, nighttime symptoms, and exacerbation frequency. Similar percentages (21-29%) of children within each severity group of asthma reported month-to-month or seasonal increases in cough, wheezing, chest tightness, shortness of breath, and panting caused by exercise during the previous year. Decreas- es in symptoms for all severities that occurred during the past year also were reported for substantial percentages of children (18-20%), and gen- eral symptom variability (ie, increases interspersed with decreases) was reported for an additional 15-23%. CONCLUSIONS: Children with persistent asthma experience symptom variability with both increases and decreases in symptoms over time regardless of disease severity. Periodic reassessment of ongoing treatment regimens is therefore appropriate in the management of childhood asthma. Funding: AstraZeneca, LP J ALLERGY CLIN IMMUNOL Abstracts S279 VOLUME 113, NUMBER 2 TUESDAY

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Page 1: Symptom variability in children with persistent asthma*1A survey of child caregivers

1012 Symptom Variability in Children With Persistent Asthma: ASurvey of Child Caregivers

K. R. Murphy1, P. Marcus2, A. Rahman3, C. O’Brien3; 1Midwest Chil-dren’s Chest Physicians, Omaha, NE, 2New York College of Osteopathic

Medicine, Old Westbury, NY, 3AstraZeneca, LP, Wilmington, DE.RATIONALE: Patients with asthma may experience periods of increaseor decrease of symptoms, which may require an increase (adjustingupward) or decrease (adjusting downward) of controller therapy. This sur-vey questioned caregivers of children with caregiver-identified mild, mod-erate, and severe persistent asthma to assess the extent of variability ofdisease symptoms in a pediatric population.METHODS: 23,888 prospective participants were selected from a USdatabase of almost 200,000 patients with asthma and invited to completean Internet-based survey conducted between September 19 and October16, 2002. Respondents were eligible to participate if they were caring fora child 6 to 18 years of age identified as having persistent asthma for atleast 1 year.RESULTS: Completed questionnaires were obtained from caregivers ofchildren identified as having mild (n=200), moderate (n=192), and severe(n=99) persistent asthma based on symptom frequency, nighttime symp-toms, and exacerbation frequency. Similar percentages (21-29%) of chil-dren within each severity group of asthma reported month-to-month orseasonal increases in cough, wheezing, chest tightness, shortness ofbreath, and panting caused by exercise during the previous year. Decreas-es in symptoms for all severities that occurred during the past year alsowere reported for substantial percentages of children (18-20%), and gen-eral symptom variability (ie, increases interspersed with decreases) wasreported for an additional 15-23%.CONCLUSIONS: Children with persistent asthma experience symptomvariability with both increases and decreases in symptoms over timeregardless of disease severity. Periodic reassessment of ongoing treatmentregimens is therefore appropriate in the management of childhood asthma.Funding: AstraZeneca, LP

J ALLERGY CLIN IMMUNOL Abstracts S279VOLUME 113, NUMBER 2

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