The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #65941

Shalaka S Netravali, MS¹, Gireesh V Gupchup, PhD², and Patricia Marshik, Pharm D². (1) VA Cooperative Studies Program, Clinical Research Pharmacy Coordinating Center, Department of Veterans Affairs, 2401 Centre Avenue, SE, Albuquerque, NM 87106, 505-265-1711, shalaka.netravali@csp.research.med.va.gov, (2) College of Pharmacy, University of New Mexico, 2502 Marble North, Albuquerque, NM 87131

Purpose: To determine: 1) the impact of parents’/caregivers’ asthma management on utilization (emergency care, urgent care, and scheduled visits) by their asthmatic child and 2) the impact of asthma management on parents’/caregivers’ health-related quality of life (HRQOL). Methods: Parents/caregivers of pediatric asthma patients between the ages of 7-17, who consented to participate were included in the study. Data were collected in the General Pediatric and Pediatric Pulmonary Clinics in the University of New Mexico Health Sciences Center-Children’s Hospital. Parents/caregivers reported information about demographics, insurance coverage, asthma education received, and smoking habits. Information regarding asthma management, HRQOL, perceived asthma severity of their child, stress, and their child’s observed medication adherence were obtained by administering the Asthma Management Scale (that includes barriers to managing asthma, asthma self-efficacy, and treatment efficacy scales), the Pediatric Asthma Caregivers Quality of Life (PACQOL) questionnaire, Asthma Severity scale, Perceived Stress scale, and modified Morisky’s medication adherence scale, respectively. Results: A response rate of 89% (100 useable questionnaires of 112) was obtained. Majority (78%) of the parents/caregivers were females. About 98% reported receiving asthma education during their clinic visit. Only 12% reported self-smoking habits and 14% reported that immediate members of their family smoked. The objectives for the study were analyzed using hierarchical regression analyses. Asthma management did not explain a significant amount of variance in any of the utilization variables. Multicollinearity between asthma management and asthma severity (tolerance < 0.01), masked the effect of asthma management on PAQOL scores of patients. Excluding asthma severity from the regression model, asthma management explained significant (F (15, 84) = 3.846, R2 change for asthma management = 0.124, p = 0.01) amount of variance in PACQOL scores. Also, in the overall model, asthma management was a significant predictor (B = 0.216, p = 0.001) of PACQOL scores. Conclusions: The results suggested that parents/caregivers of asthmatic patients who had higher asthma management skills had better health-related quality of life. Asthma management programs should focus on developing strategies that enhance parents’/caregivers’ beliefs about effectively managing their child’s asthma. Also, further research should focus on determining the impact of parents’/caregivers’ asthma management strategies on utilization by their asthmatic children.

Learning Objectives:

• At the conclusion of this session, the participant will be able to: Describe the impact of asthma management with emphasis on parent’s barriers to managing asthma, asthma self-efficacy, and beliefs in treatment efficacy on health-related quality of life.

Keywords: Asthma, Disease Management

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.