Limited agreement between current and long-term asthma control in children: the PACMAN cohort study

Authors

  • Ellen S. Koster,

    1. Division of Pharmacoepidemiology & Clinical Pharmacotherapy, Utrecht Institute for Pharmaceutical Sciences (UIPS), Faculty of Science, Utrecht University, Utrecht, The Netherlands
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  • Jan A. M. Raaijmakers,

    1. Division of Pharmacoepidemiology & Clinical Pharmacotherapy, Utrecht Institute for Pharmaceutical Sciences (UIPS), Faculty of Science, Utrecht University, Utrecht, The Netherlands
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  • Susanne J. H. Vijverberg,

    1. Division of Pharmacoepidemiology & Clinical Pharmacotherapy, Utrecht Institute for Pharmaceutical Sciences (UIPS), Faculty of Science, Utrecht University, Utrecht, The Netherlands
    2. Department of Pulmonary Diseases, University Medical Center Utrecht, Utrecht, The Netherlands
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  • Leo Koenderman,

    1. Department of Pulmonary Diseases, University Medical Center Utrecht, Utrecht, The Netherlands
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  • Dirkje S. Postma,

    1. Department of Pulmonology, University Medical Center Groningen, Groningen, The Netherlands
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  • Gerard H. Koppelman,

    1. Department of Paediatric Pulmonology and Paediatric Allergology, Beatrix Children’s Hospital, University Medical Center Groningen, Groningen, The Netherlands
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  • Cornelis K. van der Ent,

    1. Department of Paediatric Pulmonology, Wilhelmina Children’s Hospital, University Medical Center Utrecht, Utrecht, The Netherlands
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  • Anke-Hilse Maitland-van der Zee

    1. Division of Pharmacoepidemiology & Clinical Pharmacotherapy, Utrecht Institute for Pharmaceutical Sciences (UIPS), Faculty of Science, Utrecht University, Utrecht, The Netherlands
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Errata

This article is corrected by:

  1. Errata: Erratum Volume 23, Issue 5, 503, Article first published online: 23 July 2012

Anke-Hilse Maitland-van der Zee, Division of Pharmacoepidemiology & Clinical Pharmacology, Faculty of Science, Utrecht University, PO Box 80082, 3508 TB Utrecht, the Netherlands.
Tel.: 0031 622736715
Fax: 0031 302539166
E-mail: a.h.maitland@uu.nl

Abstract

To cite this article: Koster ES, Raaijmakers JAM, Vijverberg SJH, Koenderman L, Postma DS, Koppelman GH, van der Ent CK, Maitland-van der Zee A-H. Limited agreement between current and long-term asthma control in children: the PACMAN cohort study. Pediatr Allergy Immunol 2011: 22: 776–783

Abstract

Background:  Several studies have shown that predictors of asthma treatment outcomes differ depending on the definition of the outcome chosen. This provides evidence that different outcomes studied may reflect distinct aspects of asthma control. To assess predictors of asthma control, we need firm outcome phenotypes. The aim of this study was to investigate the association between measurements of current and long-term asthma control.

Methods:  We included 527 children using inhaled corticosteroids participating in the Pharmacogenetics of Asthma medication in Children: Medication with ANti-inflammatory effects cohort. Current asthma control (previous week) was defined using the Asthma Control Questionnaire. Long-term asthma control was based on Global Initiative for Asthma guidelines. Not well-controlled asthma in a season was defined as ≥3 of the following items present in a season: (i) day-time or (ii) night-time symptoms, (iii) limitations in activities, and (iv) rescue medication use. Asthma control during (i) the previous season and (ii) the year preceding the pharmacy visit was used as long-term asthma control definitions. Current and long-term asthma control were compared to investigate agreement.

Results:  Long-term uncontrolled asthma rates were highest in autumn and winter (50%) and lowest in summer (32%) (p < 0.05). Overall agreement between current and long-term asthma control was limited (66% for previous season and 68% for previous year).

Conclusion:  Congruence between current and long-term asthma control was limited. Furthermore, we showed significant seasonal differences. It is therefore important to calculate asthma control over a longer period of time, instead of using current asthma control as indicator.

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