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Observational Study
. 2018 Jan-Feb;6(1):169-176.e2.
doi: 10.1016/j.jaip.2017.05.027. Epub 2017 Aug 9.

Asthma Exacerbations and Triggers in Children in TENOR: Impact on Quality of Life

Bradley E Chipps  1 , Tmirah Haselkorn  2 , Karin Rosén  3 , David R Mink  4 , Benjamin L Trzaskoma  3 , Allan T Luskin  5
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Free article
Observational Study

Asthma Exacerbations and Triggers in Children in TENOR: Impact on Quality of Life

Bradley E Chipps et al. J Allergy Clin Immunol Pract. 2018 Jan-Feb.
Free article

Abstract

Background: Data examining associations between asthma exacerbations, triggers, and asthma-related quality of life (QOL) in children with severe/difficult-to-treat asthma are unavailable.

Objective: To evaluate real-world data on relationships between asthma exacerbations, triggers, and QOL in children using data from TENOR (The Epidemiology and Natural History of Asthma Outcomes and Treatment Regimens), a 3-year observational study of patients with severe/difficult-to-treat asthma, including those aged 6 to 12 years.

Methods: QOL was examined using the Pediatric Asthma Quality of Life Questionnaire (PAQLQ) and defined exacerbations hierarchically (descending order of severity): hospitalization, emergency department visit, steroid burst, no exacerbation, using the highest value from months 6 and 12. One-way ANOVA was used to test for differences in PAQLQ domain scores at month 12 across exacerbation severity, total number of asthma exacerbations, and number of baseline asthma triggers. Mantel-Haenszel chi-square test was used to test the association between the number of triggers and exacerbation hierarchy.

Results: Greater severity of asthma exacerbations was associated with significantly (P < .001) lower mean PAQLQ domain scores, indicating poorer QOL. A higher number of asthma exacerbations was associated with significantly (P < .001) lower mean PAQLQ domain scores. PAQLQ scores were significantly lower with higher numbers of baseline triggers. Higher baseline number of asthma triggers was associated with greater severity (P = .05) and number of asthma exacerbations (P < .001).

Conclusions: A higher number of asthma triggers at baseline was associated with greater asthma severity and number of asthma exacerbations and lower QOL in children with severe/difficult-to-treat asthma.

Keywords: Asthma triggers; Asthma-related quality of life; Difficult-to-treat asthma; Pediatric asthma; Severe asthma; Severe exacerbations.

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