The severity of asthma and the quality of life in children

It is still not clear whether severity of asthma influences quality of life in children. The purpose of this study was to compare the quality of life in infants with mild, moderate and severe asthma. Methods: Health related quality of life (HRQOL) in 89 asthmatic children (7-13 years) and their parents was measured with a generic and two disease-specific questionnaires (TNO-AZL Child Quality of Life Questionnaires, TACQOL-generic, TACQOL-asthma and the Paediatric Asthma Quality of Life Questionnaire (PAQLQ). Children were divided in three grades of severity of asthma, according to Dutch treatment guidelines. Parents graded severity on a scale (Likert 1-7). Results: 84 children were allocated into three groups, mild (12%), moderate (41.5%), and severe asthma (46.5%) based on medication needed to minimise symptoms. Quality of life was lower in more severe asthma as reported in generic and disease-specific questionnaires completed by children and parents. Correlation between HRQOL scores of parents and children was moderate. A poor agreement was found between severity grades according to the physician and the parents. Conclusion: The perception of quality of life in paediatric asthma was related to severity. Parents and children indicated a lower quality of life in more severe asthma. Asthma was often graded more severe by the paediatrician than by the parents. It is recommended to use quality of life measures for parents and children in clinical practice. The goal would be to attune perceptions about severity and impact of problems between parents, children and doctor and to improve quality of treatment