General and Disease-specific Scales in Children with Asthma and their Parents

Quality of Life of Children with Allergic Disease: The effect of Depression and Anxiety of Children and Their Mothers

Introduction: In comparison with the general population, several studies have reported higher anxiety and depression rates not only in children with allergic diseases but also in their parents. We aimed to evaluate the mental health of children and their mothers affecting quality of life (QoL) in children with allergic diseases, and to compare anxiety and depression in these patients and their parents with the general population.Methods: One hundred and sixty-eight patients aged 8-18 years diagnosed with an allergic disease who visited our outpatient clinic and a control group of 61 children who did not have any chronic or allergic diseases were included in the study. Patients completed the Pediatric QoL Inventory, Trait Anxiety Inventory for Children, and Children's Depression Inventory, while mothers completed the General Anxiety Disorder-7 (GAD-7) scale and the Patient Health Questionnaire-9 (PHQ-9). Independent samples' t-test was used to compare children's QoL, trait anxiety, and depression scores and mothers' GAD-7 and PHQ-9 scores between the controlled/mild and uncontrolled/moderate-severe groups. The effects of age, gender, disease severity, maternal depression/anxiety, and children's depression/anxiety on QoL were analyzed with multivariate regression analyses.Results: QoL was lower in children with allergic diseases than healthy children, and although the mean QoL score was lower in the group with high disease severity, QoL in children with allergic diseases was not associated with disease severity but inversely related to anxiety/depression and maternal depression.Conclusions: As per the results, QoL is impaired in children with allergic diseases. Both anxiety/depression in the child and maternal depression may adversely affect QoL in these patients.

Implementation of the Asthma Control Test in Primary Care to Improve Patient Outcomes

BACKGROUND

Asthma is one of the major chronic diseases in the pediatric population, affecting 9.5% of children. The National Heart, Lung, and Blood Institute recommends the use of the Asthma Control Test (ACT) for periodic assessment of asthma control. The purpose of this evidence-based project was to implement the Asthma Control Test screening tool into the primary care practice to improve management of patients with asthma by more accurately addressing asthma control.

METHODS

The project was a pre- and post-implementation study comparing two different groups of patients with asthma seen at the clinic over 5-week periods.

RESULTS

After the implementation of the educational program and project, 82.6% of advanced practice registered nurses and 30.7% of pediatric resident physicians used an Asthma Control Test, resulting in identification of 9 (21%) patients who were considered not well-controlled. All (100%) of those children identified as not well-controlled through the Asthma Control Test received an adjustment in their medication therapy.

CONCLUSIONS

The Childhood ACT and ACT are simple, self-administered, validated questionnaires that can easily be incorporated into a primary care practice to assess the level of asthma control and to identify patients with asthma that is not well controlled.