477 - A mismatch between teen perceptions of asthma control and reported symptoms and limitations: An opportunity for enhancing preventive care

Publication Number: 477.4015

Reynaldo S. Tajon, University of Rochester School of Medicine and Dentistry, ROCHESTER, NY, United States; Maria Fagnano, University of Rochester School of Medicine and Dentistry, Rochester, NY, United States; Sean M. Frey, University of Rochester School of Medicine and Dentistry, Rochester, NY, United States; Jill S.. Halterman, Golisano Children's Hospital at The University of Rochester Medical Center, Rochester, NY, United States; Michael H. Chen, Golisano Children's Hospital at The University of Rochester Medical Center, Pittsford, NY, United States

Background: Adolescence is a time of increasing patient responsibility for routine asthma care, often leading to decreased adherence with daily preventive medication and increased morbidity. A better understanding of how teen perceptions of asthma control relate to reported symptoms and activity limitation may help to improve asthma care delivery during this vulnerable time.

Objective: To explore the relationship between teen perceptions of asthma control, symptoms, quality of life (QOL), and activity limitation.

Design/Methods: We analyzed baseline data from the Telemedicine Enhanced Asthma Management – Uniting Providers for Teens (TUFT) study (Rochester, NY; 2020-24), aimed at enhancing asthma care through school-based telemedicine visits with specialists and a trial of supervised medication administration in school. Participants included 11-17 year olds with caregiver-reported moderate-severe or poorly controlled asthma. At baseline, teens reported recent symptoms, activity limitations, and asthma-related QOL. Teens rated their asthma control, with responses dichotomized as ‘Well Controlled / Very Well Controlled’ (well controlled) or ‘Somewhat Controlled / Poorly Controlled / Very Poorly Controlled’ (not well controlled). We used bi-variate analyses to compare symptoms, QOL and activity limitations between teens in the ‘well controlled’ and ‘not well controlled’ groups

Results: The analysis included 225 teens (55% male, 56% Black, 37% Hispanic, mean age 13.8 yrs, Table 1). More than half (59%) perceived that their asthma was ‘well controlled’. While ‘well controlled’ teens reported significantly fewer symptoms and a better QOL than ‘not well controlled’ teens, those reporting good control averaged only 8.8 symptom-free days in the prior 14 days. This group also reported several days in which they required rescue medicine, had nighttime symptoms, or needed to reduce their activity (Table 2). In fact, 50% of teens in this ‘well controlled’ group reported activity limitations in gym class and 62% were limited in sports/running (Fig. 1). Fewer than ½ of all teens reported current use of a daily preventive medication.

Conclusion(s): Teens who perceive their asthma as well controlled report less asthma morbidity, yet continue to experience frequent symptoms and substantial activity limitation. Use of preventive treatment was suboptimal regardless of perceptions about control. Specific questions on symptoms and functional limitations are needed to thoroughly assess asthma control and guide decisions on appropriate preventive therapy for this population.

TABLE 1: Demographic Characteristics of Teen Participants
Table 1.pdf

TABLE 2: Teen perception of asthma control and reported symptoms, preventive medication use, and quality of life
Table 2.pdf^Symptoms reported as number of days symptoms occurred in the prior two weeks (range 0-14 days).
*Asthma Related Quality of Life scores range from 1-7, with higher scores indicating better quality of life.

Figure 1. Asthma-related activity limitation by perception of asthma control
Figure 1.pdf*Indicates differences between groups at p-value <.05