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Impact of guideline adherence and race on asthma control in children

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Abstract

Background

Asthma control in African Americans (AA) is considered more difficult to achieve than in Caucasian Americans (CA). The aim of this study was to compare asthma control over time among AA and CA children whose asthma is managed per NAEPP (EPR-3) guidelines.

Methods

This was a one-year prospective study of children referred by their primary care physicians for better asthma care in a specialty asthma clinic. All children received asthma care per NAEPP guidelines. Results were compared between CA and AA children at baseline and then at three-month intervals for one year.

Results

Of the 345 children, ages 2–17 years (mean = 6.2 ± 4), 220 (63.8%) were CA and 125 (36.2%) were AA. There were no significant differences in demographics other than greater pet ownership in CA families. At baseline, AA children had significantly more visits to the Emergency Department for acute asthma symptoms (mean = 2.3 \(\pm 3)\) compared to CA (1.4 ± 2.3, P = 0.003). There were no other significant differences in acute care utilization, asthma symptoms (mean days/month), or mean asthma control test (ACT) scores at baseline. Within 3–6 months, in both groups, mean ACT scores, asthma symptoms and acute care utilization significantly improved (P < 0.05 for all) and change over time in both groups was comparable except for a significantly greater decrease in ED visits in AA children compared to CA children (P = 002).

Conclusion

Overall, improvement in asthma control during longitudinal assessment was similar between AA and CA children because of  consistent use of NAEPP asthma care guidelines.

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Authors and Affiliations

  1. Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA

    Shahid I. Sheikh, Nancy A. Ryan-Wenger, Grace Paul & Lisa Ulrich

  2. Section of Pulmonary Medicine, Nationwide Children’s Hospital, ED 544 Education Building, 700 Children’s Drive, Columbus, OH, USA

    Shahid I. Sheikh, Judy Pitts, Grace Paul & Lisa Ulrich

  3. Department of Perinatal Research, Wexner Research Center, Columbus, OH, USA

    Rodney Britt Jr

Authors
  1. Shahid I. Sheikh
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  2. Nancy A. Ryan-Wenger
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  3. Judy Pitts
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  4. Rodney Britt Jr
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  5. Grace Paul
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  6. Lisa Ulrich
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Contributions

Conceptualization: SIS. Data curation and formal analysis: NAR-W. Methodology: SIS, JP, RB, LU. Supervision: SIS, RB, GP, LU. Writing—original draft: SIS, NAR-W, JP, RB, GP, LU. Writing—review and editing: SIS, NAR-W, JP, RB, GP, LU. We have seen and approved the final version submitted for publication and take full responsibility for the manuscript.

Corresponding author

Correspondence to Shahid I. Sheikh.

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Ethical approval

This study was approved by the Institutional Review Board of Nationwide Children’s Hospital Research Center (IRB11-00,174). Informed consent and child assent was waived.

Conflict of interest

No financial or non-financial benefits have been received or will be received from any party related directly or indirectly to the subject of this article. None of the authors serves as a current or past editorial board member of WJP.

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Sheikh, S.I., Ryan-Wenger, N.A., Pitts, J. et al. Impact of guideline adherence and race on asthma control in children. World J Pediatr 17, 500–507 (2021). https://doi.org/10.1007/s12519-021-00458-5

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  • DOI: https://doi.org/10.1007/s12519-021-00458-5

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