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J Allergy Clin Immunol. 2015 Jun;135(6):1444-9. doi: 10.1016/j.jaci.2014.11.008. Epub 2014 Dec 19.

Asthma outcomes in children and adolescents with multiple morbidities: Findings from the National Health Interview Survey.

Author information

1
Department of Health Behavior and Health Education, University of Michigan, Ann Arbor, Mich. Electronic address: minalrp@umich.edu.
2
Center for Managing Chronic Disease, University of Michigan, Ann Arbor, Mich; St Joseph Mercy Hospital, Ann Arbor, Mich.
3
Center for Managing Chronic Disease, University of Michigan, Ann Arbor, Mich; Department of Internal Medicine, University of Michigan, Ann Arbor, Mich.
4
Department of Biostatistics, University of Michigan, Ann Arbor, Mich.
5
Center for Managing Chronic Disease, University of Michigan, Ann Arbor, Mich.

Abstract

BACKGROUND:

More Americans are managing multiple chronic conditions (MCCs), and trends are particularly alarming in youth.

OBJECTIVE:

The purpose of this study was to examine the prevalence and distribution of 9 chronic conditions in children and adolescents with and without asthma, and adverse asthma outcomes associated with having MCCs.

METHODS:

Cross-sectional interview data from the National Health Interview Survey were analyzed (N = 66,790) between 2007 and 2012 in youth 0 to 17 years of age. Bivariate analysis methods and multivariate generalized linear regression were used to examine associations.

RESULTS:

Five percent of children with asthma had 1 or more coexisting health conditions. The prevalence of 1 or more comorbidities was greater among those with asthma than those without (5.07% [95% CI: 4.5-5.6] vs. 2.73% [95% CI: 2.6-2.9]). Those with asthma were twice as likely to have co-occurring hypertension (prevalence ratio [PR] = 2.2 [95% CI: 1.5-3.2]) and arthritis (PR = 2.7 [95% CI: 1.8-4.0]) compared with those without asthma. Every additional chronic condition with asthma was associated with a greater likelihood of an asthma attack (PR = 1.1 [95% CI: 1.0-1.2]), all-cause emergency department visits (PR = 1.3 [95% CI: 1.1-1.5]), and missed school days (PR = 2.3 [95% CI: 1.7-3.2]).

CONCLUSIONS:

Children and adolescents with asthma in the US who suffer from MCCs have increased asthma symptoms, missed school days, and all-cause emergency department visits. Further research on optimal management strategies for this group is needed.

KEYWORDS:

Outcomes; asthma; comorbidity; epidemiology; pediatrics

PMID:
25533524
DOI:
10.1016/j.jaci.2014.11.008
[Indexed for MEDLINE]

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