Caregiver Perceptions of Change in Pediatric Asthma Control During the COVID-19 Pandemic

Abstract

Purpose

Although several indicators suggest that pediatric asthma control in the United States improved early in the pandemic, other indicators suggest not. Missing are reports from caregivers of the experiences of their children with asthma early in the pandemic.

Methods

Using the PP-ACT and other measures that we specifically constructed for our research, we conducted a cross-sectional national survey of US caregivers of children with asthma (N=595) to examine perceived change in their child’s asthma control and changes in reports of ED visits and use of emergency relief medicine and controller medicine pre-pandemic (January to March 2020) versus early-pandemic (June to September 2020).

Results

Caregivers fell into three groups: most caregivers perceived that their child’s asthma control was improved (50.3%) or unchanged (41.2%), and few reported worse control (8.5%). Surprisingly, all three groups of caregivers reported similar frequencies of early-pandemic and pre-pandemic ED visits and use of emergency relief medicine. Also surprising, caregivers who perceived their child’s asthma as more controlled (compared with the other two groups) reported more frequent ED visits and use of emergency relief medicine, yet also more use of controller medicine at both early-pandemic and pre-pandemic.

Conclusion

The mismatch between caregivers’ perceptions of their child’s early-pandemic asthma control and their reports of ED visits and use of emergency relief medicine suggests that caregivers may rely on a gist (a global evaluation that can include nonbiomedical evidence) when estimating their child’s asthma control. Caregivers and their families could benefit from help from clinicians in understanding the discrepancy between subjective asthma control and asthma control indicators and in understanding what well-controlled asthma looks and feels like.

Keywords:

• PP-ACT
• childhood asthma
• ED admissions
• coronavirus 19 pandemic
• asthma caregivers
• United States
• perceptions

Data Sharing Statement

The data that support the findings of this study are openly available at the OSF project page at https://osf.io/87kpr.

Acknowledgments

This research was supported by the US National Institutes of Health (R01HL137680, MPI Erika Waters, James Shepperd) and the Washington University Institute of Clinical and Translational Sciences grant UL1TR002345 from the National Center for Advancing Translational Sciences (NCATS) of the National Institutes of Health (NIH). The content is solely the responsibility of the authors and does not necessarily represent the official view of the NIH. The funder had no role in the collection, analysis, or interpretation of the data, the writing of the report, or the decision to submit the manuscript.

Disclosure

The authors report no conflicts of interest.