Abstract
BACKGROUND: Data on the impact of the number and nature of perceived asthma triggers on health-related quality of life (HRQL) in children are scarce. OBJECTIVE: To investigate the impact of perceived asthma triggers on both asthma-specific and generic HRQL in children. METHODS: A cross-sectional study was conducted among children (7-18 years) with asthma in secondary and tertiary care. Children were screened with electronic questionnaires regarding respiratory and allergic symptoms. Asthma-specific HRQL was assessed using the Pediatric Asthma Quality of Life Questionnaire (PAQLQ) (score range 1-7) and generic HRQL using the RAND questionnaire (score range 7-32). The Kruskal-Wallis test and one-way ANOVA were used to test the difference of, respectively, the PAQLQ and RAND scores across the number of perceived asthma triggers (0, 1-2, 3-4, or ≥ 5). Univariable and multivariable linear regression analyses were performed to evaluate the association between individual triggers and HRQL. RESULTS: A total of 527 children with a mean (SD) age of 12.1 (2.9) years were included. Children with a higher number of perceived triggers had significantly lower PAQLQ and RAND scores (ie poorer HRQL). The difference in PAQLQ scores was clinically relevant between children with 0 versus 3-4 or ≥ 5 triggers and 1-2 versus ≥ 5 triggers (mean difference 0.66, 1.02 and 0.63, respectively). Especially, non-allergic triggers (physical exercise, the weather, (cigarette) smoke and emotions) were significantly associated with reduced PAQLQ scores. Emotions and food/drinks were associated with reduced RAND scores. CONCLUSION AND CLINICAL RELEVANCE: A higher number of perceived triggers of asthma were associated with reduced HRQL in children with asthma. Especially, non-allergic triggers were associated with reduced HRQL.