• Sergey Kunkov and Ellen F Crain.
• Division of Pediatric Emergency Medicine, Department of Pediatrics, Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA. sergey.kunkov@gmail.com
• J Asthma. 2010 Jun 1;47(5):545-50.

ObjectivesTo explore the utility of two measures, Risk for Nonadherence (RN) and Admitted Nonadherence (AN), developed in a national sample of children with chronic asthma, for predicting short-term morbidity among children following a pediatric emergency department (PED) visit for acute asthma and to compare verbal and self-completion of these measures.Design, Setting, And ParticipantsProspective cohort study of children 3 to 11 years of age presenting to a PED with an acute asthma exacerbation. Caretakers were randomized to self-completion of a questionnaire assessing RN and AN or to verbally respond to the same questionnaire administered by a research assistant. Five asthma morbidity indicators were collected at 2, 4, and 8 weeks following discharge from the PED.ResultsOne hundred fifty-four patients were enrolled. There were no significant differences in asthma severity, RN, or AN, or the number of items missing on questionnaires between the self-completion and verbal administration groups. Patients with a RN score >4 had an adjusted odds of 3.67 (95% confidence interval [CI] 1.57-8.58) for waking >2 nights due to asthma symptoms. The adjusted odds of patients with any AN to report needing >4 days of rescue asthma medication was 3.16 (95% CI 1.37-7.26).ConclusionRN and AN were both associated with morbidity indices following an acute asthma exacerbation and can identify children at risk for increased short-term morbidity regardless of the method of questionnaire administration. Assessment of RN and AN by self-administered questionnaire during an ED visit for asthma maybe feasible.

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