Are Our Children with Asthma and/or Allergic Rhinitis Well Controlled? A Study using CARATKids.

Introduction: Around 12.9% of children and 11.8% of adolescents suffer from asthma in Portugal, 60-80% of which have allergic rhinitis concomitantly (ARA). Clinical control evaluation is essential and there is only one validated questionnaire for Portuguese children – “Control of Allergic Rhinitis and Asthma Test for Children” (CARATKids). It consists of 8 questions for the child and 5 for their parents, with a maximum score of 13. The following cut-offs were established: ≤3: controlled disease; ≥6: uncontrolled disease.

Objective: Evaluate clinical control of ARA in a group of children attending Paediatric Allergology consults using CARATKids and study the correlation between clinical score and peak expiratory flow (PEF), allergies in skin prick tests (SPT) and medication adherence.

Methods: Observational, descriptive and transversal study, using CARATKids in children diagnosed with asthma and/or allergic rhinitis, data from SPT, PEF and medication adherence. Statistical analysis with SPSS 23.

Results: We studied 31 children, mean age of 9.3 years (min. 6, max. 12). 93% had a correct inhalator technique and 38.7% an adequate PEF. 14.8% did not follow prescribed medication. The most common sensitisations in SPT were to mites. Regarding clinical scores, 38.7% had controlled disease and 22.6% uncontrolled disease, with a mean score of 3.97. The parents’ score correlated better to the final score than the children’s (p= 0,005 vs p=0,024). Lower respiratory symptoms were statistically correlated to clinical score (p=0,016). There was no correlation between PEF or medication adherence and clinical score. Positive SPT to Gramineae and Parietaria were associated with worse clinical scores (p=0,048 e p=0,05 respectively).

Conclusion: There is a tendency to undermine asthma’s and rhinitis’ symptoms, which may explain why only one third of the patients have controlled disease. Objective tools for clinical evaluation should be used frequently, such as CARATKids, to improve therapeutic adjustments and increase clinical control.