Monitoring asthma in childhood: symptoms, exacerbations and quality of life

TABLE 1

Symptoms and consequences of asthma disease activity

Type of symptoms

Wheeze

Shortness of breath

Chest tightness

Cough

Use of rescue medication

Review use of daily controller medication

Pattern of symptoms

Daytime symptoms

Symptoms related to exercise

Night-time symptoms

Seasonality

Impact of symptoms

Limitation in sports, play and daily activities

School absenteeism

Parental work absenteeism

Impact on sleep

TABLE 2

Comparison of items in the asthma control test (ACT), childhood ACT and asthma control questionnaire (ACQ)

Item	ACT	Childhood ACT	ACQ
Nocturnal awakening	+	+ (child and parent)	+
Severity of nocturnal symptoms			+
Limitation of daily activities	+	+ (child)	+
Shortness of breath	+		+
Wheeze		+ (parent)	+
Use of rescue medication	+		+
Self-rated asthma control	+	+ (child)
Cough		+ (child)
Daytime asthma symptoms		+ (parent)

TABLE 4

Monitoring tools in research and in clinical practice

	Research tool	Use in clinical practice	Comments
Symptoms/limitation of activities/use of reliever medication	Yes	Yes	Also discuss adherence to maintenance medication; ensure proper inhalation technique
Exacerbations	Yes	Yes	Review exacerbations that have occurred and their potential triggers
Quality of life questionnaires	Yes	No	Discussing impact on daily life is part of normal clinical history
*Composite asthma control measures, e.g.* ACT or ACQ**	Yes	No	Short recall window do not take exacerbations and exercise limitations into account