Asthma Flare-up Diary for Young Children to monitor the severity of exacerbations

Ducharme, Francine M; Jensen, Megan E.; Mendelson, Morton J.; Parkin, Patricia C.; Desplats, Eve; Zhang, Xun; Platt, Robert W.

doi:10.1016/j.jaci.2015.07.028

Cited by 20 publications

(20 citation statements)

References 33 publications

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“…The swab was transported by courier for storage at -80 °C before polymerase chain reaction (PCR) analysis [ 23 ] for 26 viruses (Laval University, Quebec City, QC, Canada). Parents also completed three questionnaires: the Canadian Acute Respiratory Illness and Flu Scale (CARIFS) [ 24 ]; the Asthma Flare-up Diary for Young Children (ADYC) [ 25 ]; and the Effects of an Asthma Flare-up on the Parents (ECAP) [ 26 ].…”

Section: Methodsmentioning

confidence: 99%

Vitamin D intervention in preschoolers with viral-induced asthma (DIVA): a pilot randomised controlled trial

Jensen

Mailhot

Alos

et al. 2016

Trials

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BackgroundTrials in school-aged children suggest vitamin D supplementation reduces asthma exacerbations. Primary aim: to examine whether vitamin D3 (100,000 IU) rapidly raises serum 25-hydroxyvitamin D (25OHD) ≥75 nmol/L in asthmatic preschoolers.MethodsIn a double-blind, randomised, placebo-controlled trial, preschool-aged children with asthma received 100,000 IU vitamin D3 (intervention) or placebo (control), followed by 400 IU vitamin D3 daily for 6 months. Serum 25OHD was measured at baseline, 10 days, 3 and 6 months. Outcomes included the group difference in 25OHD change from baseline at 3 months (Δ25OHD); the proportion of children with 25OHD ≥75 nmol/L at 3 months; the pattern in serum vitamin D over 6 months; the proportion of children with hypercalciuria at any time point (safety); and group rates for oral corticosteroids. Continuous outcomes were analysed using generalised linear mixed models and group rate ratios of events per child were assessed using a Poisson distribution model.ResultsTwenty-two children were randomised (intervention:11; control:11) during winter. At 3 months, the group difference in Δ25OHD (7.2 nmol/L; 95 % CI: -13.7, 28.1) was not significant; yet, 100 % versus 54.5 % (intervention versus control) had serum 25OHD ≥75 nmol/L. There was a significant group difference in Δ25OHD at 10 days (110.3 nmol/L; 95 % CI: 64.0, 156.6). One child in each group had transient hypercalciuria at 10 days. Group oral corticosteroids rates were 0.82 and 1.18/child, intervention versus control (rate ratio = 0.68; 95 % CI: 0.30, 1.62; non-significant).ConclusionsFollowing 100,000 IU vitamin D3, all children reached serum 25OHD ≥75 nmol/L, compared with half who received placebo. Daily supplementation, sun exposure and insufficient power may explain the absence of a significant 3-month group difference in Δ25OHD. No clinically important alterations in bone metabolism biomarkers occurred. Group oral corticosteroid rates will inform sample size calculations for the larger trial. (NCT01999907, 25 November 2013).Electronic supplementary materialThe online version of this article (doi:10.1186/s13063-016-1483-1) contains supplementary material, which is available to authorized users.

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Section: Methodsmentioning

confidence: 99%

Vitamin D intervention in preschoolers with viral-induced asthma (DIVA): a pilot randomised controlled trial

Jensen

Mailhot

Alos

et al. 2016

Trials

Self Cite

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“…During a flare-up or URTI, parents are instructed to collect a nasal swab and complete: (1) the validated 17-item Asthma Flare-up Diary for Young Children (ADYC)71 daily throughout the event to document symptoms and, at the end of the event, both the (2) validated 21-item Effect of a Child’s Asthma flare-up on Parents ( ECAP ) questionnaire72 to measure parental quality of life and (3) summary-of-event form to capture healthcare utilisation, including hospital/pharmacy name. Parent collection of nasal swabs has been shown to be comparable to physician collection 73.…”

Section: Methods and Designsmentioning

confidence: 99%

“…The mean number of URTIs will be quantified via PCR analysis of nasal swabs, collected by parents during an exacerbation. The ADYC 71 is used to ascertain the severity (sum of the daily score) and duration (cumulative number of days with symptoms) of symptoms, and the intensity of rescue β 2 -agonist use (cumulative daily number of puffs), during an exacerbation. The ECAP questionnaire72 will capture parental functional status during an exacerbation.…”

Section: Methods and Designsmentioning

confidence: 99%

Vitamin D in the prevention of exacerbations of asthma in preschoolers (DIVA): protocol for a multicentre randomised placebo-controlled triple-blind trial

et al. 2019

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IntroductionPreschoolers have the highest rate of emergency visits and hospitalisations for asthma exacerbations of all age groups, with most triggered by upper respiratory tract infections (URTIs) and occurring in the fall or winter. Vitamin D insufficiency is highly prevalent in Canadian preschoolers with recurrent asthma exacerbations, particularly in winter. It is associated with more URTIs and, in patients with asthma, more oral corticosteroid (OCS) use. Although evidence suggests that vitamin D supplements significantly decrease URTIs and asthma exacerbations requiring OCS, there is insufficient data in preschoolers. This study aims to determine the impact of vitamin D3 supplementation on exacerbations requiring OCS, in preschoolers with recurrent URTI-induced asthma exacerbations.Methods and analysisThis is a phase III, randomised, triple-blind, placebo-controlled, parallel-group multicentre trial of vitamin D3 supplementation in children aged 1–5 years, with asthma triggered by URTIs and a recent history of frequent URTIs and OCS use. Children (n=865) will be recruited in the fall and early winter and followed for 7 months. They will be randomised to either the (1) intervention: two oral boluses of 100 000 international unit (IU) vitamin D3 (3.5 months apart) with 400 IU vitamin D3 daily; or (2) control: identical placebo boluses with daily placebo. The primary outcome is the number of exacerbations requiring OCS per child, documented by medical and pharmacy records. Secondary outcomes include number of laboratory-confirmed viral URTIs, exacerbation duration and severity, parent functional status, healthcare use, treatment deintensification, cost and safety.Ethics and disseminationThis study has received ethical approval from all sites. Results will be disseminated via international conferences and manuscripts targeting paediatricians and respirologists, and to families of asthmatic children via our Quebec parents–partners outreach programme. If proven effective, findings may markedly influence the management of URTI-induced asthma in high-morbidity preschoolers and could be directly implemented into practice with an update to clinical guidelines.Trial registration numberNCT03365687.

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“…There is also a version that is designed to be answered by parents 15 16. There are two other instruments attempting to assess the severity of preschool wheeze attacks and the main parental feelings during the episode 17 18. Although these instruments demonstrate how families feel during acute attacks, they do not capture the changes in quality of their life over time and are not co-designed with families, unlike PROMs.…”

Section: Are There Suitable Proms In Children With Recurrent Wheeze?mentioning

confidence: 99%

What are patient-reported outcomes and why they are important: improving studies of preschool wheeze

Makrinioti

Bush

Griffiths

2019

Arch Dis Child Educ Pract Ed

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There are no outcomes-based commissioning structures in child health. This needs to change. Preschool wheeze is a very common condition. Many families present at emergency departments with their wheezy children and stay briefly. This highlights that this group of children may be lacking a more personalised approach. There are no user-friendly patient-reported outcome measures in preschool wheeze. This needs to change. Research in this area is therefore highly anticipated.

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Asthma Flare-up Diary for Young Children to monitor the severity of exacerbations

Abstract: The 17-item ADYC proved feasible, responsive to day-to-day changes, and discriminative across exacerbations of different severities. In a trial testing effective therapy in preschoolers, it identified a significant reduction in asthma exacerbation severity.

Cited by 20 publications

References 33 publications

Vitamin D intervention in preschoolers with viral-induced asthma (DIVA): a pilot randomised controlled trial

Vitamin D intervention in preschoolers with viral-induced asthma (DIVA): a pilot randomised controlled trial

Vitamin D in the prevention of exacerbations of asthma in preschoolers (DIVA): protocol for a multicentre randomised placebo-controlled triple-blind trial

What are patient-reported outcomes and why they are important: improving studies of preschool wheeze

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