Pediatric Asthma Impairment and Risk Questionnaire identifies children most at risk for exacerbation.

Background

Uncontrolled asthma symptoms and prior-year exacerbations increase the risk for future exacerbations in school-aged children. The Pediatric Asthma Impairment and Risk Questionnaire (Peds-AIRQ) is an 8-item, equally weighted, yes/no asthma control tool validated for children aged 5-11 years that assesses current symptoms and exacerbation history.

Objective

To determine the relationship of asthma control, as assessed by the Peds-AIRQ, and subsequent 3-month exacerbation occurrence.

Methods

At enrollment, children with asthma (aged 5-11 years) and their parents/caregivers completed a baseline Peds-AIRQ. Parent/caregiver-reported exacerbations were captured monthly for 3 months post-enrollment via electronic survey. Logistic regression models used baseline Peds-AIRQ score, asthma control category (well-controlled [WC], not well-controlled [NWC], very poorly controlled [VPC]), age, sex, race, ethnicity, and body mass index as covariates, and ≥1 subsequent 3-month exacerbation as the dependent variable.

Results

Of 399 children enrolled in the Peds-AIRQ validation study, 313 completed ≥1 follow-up survey over 3 months: mean (SD) age 7.9 (1.9) years; 63.3% boys; 71.6% White; 25.9% Hispanic/Latino. Baseline Peds-AIRQ categorized 39.3% of children as having WC asthma, 43.1% NWC, and 17.6% VPC. During the 3-month follow-up, 69 (22%) children experienced 114 exacerbations. Each 1-point increase in baseline Peds-AIRQ score was associated with 32% increased odds of ≥1 subsequent 3-month exacerbation (OR [95% CI]: 1.32 [1.16-1.51], P < .001). Children with VPC asthma had greater odds of exacerbation than those with WC (OR [95% CI]: 3.85 [1.79-8.24], P < .001) or NWC asthma (OR [95% CI]: 2.56 [1.26-5.21], P < .01).

Conclusion

At point-of-care, Peds-AIRQ can help identify children at risk for exacerbation over 3 months.