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Children With Asthma: Primary Outcome Measures

Children With Asthma: Primary Outcome MeasuresFollow-up: All randomized patients (n = 87) were observed (passively) through their medical records over the entire follow-up year. At the 12-month follow-up, interview data were obtained in person or by phone for 60 participants (69%). Twenty-seven patients were unavailable for active follow-up, despite aggressive attempts to retain them, but were not unavailable for follow-up by medical records. Urine samples were obtainable for 51 of these participants (59% of the randomized sample). The rates of retention in active follow-up did not differ between those for the intervention and control groups (30 for each group for the interview data and 25 and 26, respectively, for the urine samples). There was a tendency for those who contributed follow-up urine data to have lower CCRs at baseline (mean, 14.3; SD, 17.5) than those who did not (mean, 24.3; SD, 33.2; p = 0.07). Attrition was not significantly associated with a patient’s race, gender, or degree of health-care utilization for asthma in the baseline year. canadian health&care mall

Primary Outcome Measures
Acute Medical Visits: The proportion of children with more than one asthma-related medical visit decreased in the intervention group from 50.0% in the baseline year to 29.6% in the follow-up year, as contrasted with a slight increase, from 37.2 to 46.5%, in the control group (Table 3). The odds ratio (OR), adjusted for baseline visits, was 0.32 (p = 0.03) [ie, the odds of having more than one visit were reduced by approximately two thirds in the intervention group compared with the control group]. The bootstrap results revealed that the 95% confidence interval for the difference between the intervention and control group follow-ups in log odds, and adjusting for baseline visits, did not include zero. This supports the validity of the asymptotic results from the logistic regression analysis despite the overall strong association that exists, as would be expected, between baseline asthma visits and follow-up visits (OR, 6.2; p = 0.0005). When similar analyses were performed for the subset of children with cotinine results available for the 12-month follow-up as well as for the baseline (n = 51) [Table 2], the effects of the intervention were even more pronounced (ie, lower ORs) and were statistically significant despite the reduced sample size. The proportions of patients in the intervention group with more than one visit decreased from 52.0 to 36.0%, whereas those in the control group increased from 50.0 to 73.1% (unadjusted OR [ORu], 0.21; p = 0.01; adjusted OR [ORa], 0.16; p = 0.01). Again, the bootstrap results supported the validity of the asymptotic results, despite the strong overall association between baseline and follow-up visits (OR, 4.5; p = 0.03).
Table 3—Urine Cotinine and CCR at Baseline in Relation to Caregiver Report of Smokers and Smoking Practices

Variables No. (%) Cotinine, ng/mL CCR, ng/mg
Mean (SD) p Value* Mean (SD) p Value*
Maternal caregiver smokes
No 45 (51.7) 9.5 (12.8) 10.8(11.5)
Yes 42 (48.3) 24.6(31.8) 0.006 25.5 (32.2) 0.006
Smoking allowed inside the home
No 54 (62.1) 10.0(16.3) 11.2 (15.6)
Yes 33 (37.9) 29.2 (32.8) 0.0005 30.3 (33.3) 0.0005
Child’s typical daily exposure
None 11 (12.6) t 5.1 (9.7) 8.4(12.6)
Moderate amount 59 (67.8) 16.1 (23.7) 15.9 (23.1)
Large amount 15 (17.2) 29.3 (35.1) 0.014 33.5 (35.2) 0.008
Cigarettes smoked, | No. 27.0 (18.3) § 17.3 (25.6) 0.003 18.4 (25.5) 0.006