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. 2025 Jan;60(1):e27457.
doi: 10.1002/ppul.27457. Epub 2024 Dec 24.

Difference in the Perceptions of Asthma Control Between Children With Asthma and Their Parents

Sara Bousema  1 , Miranda E van Zwet  1 , Ieteke Ossendrijver  1 , Patrick J E Bindels  1 , Arthur M Bohnen  1 , Mariëlle Pijnenburg  2 , Madelon van Tilborg-den Boeft  1 , Gijs Elshout  1
Affiliations

Difference in the Perceptions of Asthma Control Between Children With Asthma and Their Parents

Sara Bousema et al. Pediatr Pulmonol. 2025 Jan.

Abstract

Introduction: Asthma is the most prevalent chronic condition in children in primary care. Asthma control can be quantified using the Childhood Asthma Control Test (C-ACT), which includes questions for both children and their parents. However, there can be discrepancies between children and parents in their perceptions of asthma control.

Objective: This longitudinal study determines the difference in the perceptions of asthma control between children in primary care and their parents using the C-ACT, measured at five points in time.

Method: Children aged 6-12 with asthma who are being treated in primary care were eligible. Data was obtained using electronic questionnaires from the Rotterdam Asthma Trial from baseline to 18 months follow-up. The primary outcome was a difference in C-ACT scores between parents and their children. The data was analyzed using Spearman's correlation and intraclass correlation coefficient (ICC).

Results: We included 90 children and their parents. The mean age of the children was 9.6 years (SD 1.7). At baseline, the children gave a median C-ACT score of 9/12 (IQR 2.5) and the parents gave a median score of 14/15 (IQR 3.0). Children's median C-ACT scores were significantly lower throughout the study period (p < 0.001). The Spearman test showed moderate to strong correlation (0.659-0.775, and the ICC showed good agreement (0.750-0.813).

Conclusion: This study showed that parents gave significantly higher scores for the individual items of the C-ACT than their children. Considering the child's perspective on their symptoms is crucial when deciding on additional asthma treatment measures.

Keywords: asthma; asthma control; children; parents; primary care.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Childhood asthma control test.
Figure 2
Figure 2
Median percentages of the maximum C‐ACT score.
Figure 3
Figure 3
Box plot of the percentage differences in C‐ACT scores given by children and parents at baseline and 18 months. X‐axis: percentage difference in C‐ACT scores between child and parent at baseline. Y‐axis: percentage difference in C‐ACT scores between child and parent at 18 months.
Figure 4
Figure 4
Bland–Altman plot at baseline. X‐axis: the mean of the child's and parent's scores (as a percentage) at baseline. Y‐axis: the difference between the child's and parent's scores (parent minus child) as a percentage.
Figure 5
Figure 5
Percentages of parents and children reporting nocturnal symptoms.
See this image and copyright information in PMC

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