• J Allergy Clin Immunol Pract · Mar 2014

    Validation of parental reports of asthma trajectory, burden, and risk by using the pediatric asthma control and communication instrument.

    • Sande O Okelo, Michelle N Eakin, Kristin A Riekert, Alvin P Teodoro, Andrew L Bilderback, Darcy A Thompson, Antonio Loiaza-Martinez, Cynthia S Rand, Shannon Thyne, Gregory B Diette, and Cecilia M Patino.
    • Department of Pediatrics, David Geffen School of Medicine at UCLA, Los Angeles, Calif. Electronic address: sokelo@mednet.ucla.edu.
    • J Allergy Clin Immunol Pract. 2014 Mar 1;2(2):186-92.

    BackgroundDespite a growing interest, few pediatric asthma questionnaires assess multiple dimensions of asthma morbidity, as recommended by national asthma guidelines, or use patient-reported outcomes.ObjectiveTo evaluate a questionnaire that measures multiple dimensions of parent-reported asthma morbidity (Direction, Bother, and Risk).MethodsWe administered the Pediatric Asthma Control and Communication Instrument (PACCI) and assessed asthma control (PACCI Control), quality of life, and lung function among children who presented for routine asthma care. The PACCI was evaluated for discriminative validity.ResultsA total of 317 children participated (mean age, 8.2 years; 58% boys; 44% African American). As parent-reported PACCI Direction changed from "better" to "worse," we observed poorer asthma control (P < .001), mean Pediatric Asthma Caregiver Quality of Life Questionnaire (PACQLQ) scores (P < .001), and FEV1% (P = .025). Linear regression showed that, for each change in PACCI Direction, the mean PACQLQ score decreased by -0.6 (95% CI, -0.8 to -0.4). As parent-reported PACCI Bother changed from "not bothered" to "very bothered," we observed poorer asthma control (P < .001) and lower mean PACQLQ scores (P < .001). Linear regression showed that, for each change in PACCI Bother category, the mean PACQLQ score decreased by -1.1 (95% CI, -1.3 to -0.9). Any reported PACCI Risk event (emergency department visit, hospitalization, or use of an oral corticosteroid) was associated with poorer asthma control (P < .05) and PACQLQ scores (P < .01).ConclusionsPACCI Direction, Bother, and Risk are valid measures of parent-reported outcomes and show good discriminative validity. The PACCI is a simple clinical tool to assess multiple dimensions of parent-reported asthma morbidity, in addition to risk and control.Copyright © 2014 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

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