Asthma control test to identify uncontrolled asthma  in pediatric clinical practice

International guidelines indicate that the main criterion of asthma management is asthma control level. The aim of this study was to assess asthma control and its relation with age, gender, and lung function. Material and methods. A total of 106 family physicians and 13 pulmonologists and allergists took part in this study. Each doctor had selected 10–15 asthma patients and had sent invitations to them by post. On the visit day, the patients themselves filled in the Asthma Control Test. The doctors interviewed the patients and filled in a special questionnaire. Pulmonologists and allergists also assessed lung function by performing spirometry. According to the results of the Asthma Control Test, the disease control level was indicated as “totally controlled” (25 points), “well controlled” (24–20 points), and “uncontrolled” (19 points or less). Results. A total of 876 asthma patients were examined. Uncontrolled asthma was diagnosed to 56.2% of the patients, 36.5% of patients had well controlled and 7.3% totally controlled asthma. There was no significant difference in asthma control level comparing men and women. A correlation between asthma control level and age was found revealing poorer asthma control in older patients. Ninety-five percent of patients were treated with inhaled steroids; most of them had used inhaled steroids in combination with long-acting β2 agonists. It was found that lung function correlated with clinical symptoms of asthma, the demand of shortacting β2 agonists, and asthma control level. Conclusion. The study showed that uncontrolled asthma was diagnosed to more than half of the patients, despite most of them used inhaled steroids. Asthma control was worsening with the age of patients with asthma and it correlated with lung function. We suggest that periodical assessment of asthma control should help to optimize asthma management.

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Hubungan Kadar Periostin Serum dan Nilai Asthma Control Test pada Pasien Asma di RSUD Dr. Soetomo Surabaya

Jurnal Respirasi ◽

10.20473/jr.v4-i.2.2018.33-37 ◽

2018 ◽

Vol 4 (2) ◽

pp. 33

Author(s):

Ni Made Dwita Yaniswari ◽

Muhammad Amin

Keyword(s):

Asthma Control ◽

Matrix Protein ◽

Extracellular Matrix Protein ◽

Enzyme Linked Immunosorbent Assay ◽

Control Test ◽

Uncontrolled Asthma ◽

Asthma Control Test ◽

Asthmatic Patients ◽

Act Score ◽

Serum Periostin

Background: Asthma is a heterogenous disease composed of various phenotype. Chronic airway inflammation are fundamental features of asthma. The main treatment of asthma is corticosteroid. The administration of inhaled corticosteroids will reduce the inflammatory process in asthma. Even with adequate inhaled corticosteroid treatment, there are still patients who develop symptoms with lower asthma control test score. Periostin is an extracellular matrix protein as the best single systemic biomarker for assessing tissue eosinophilia, airway remodeling in uncontrolled asthma. The objective of this study was to examine whether serum periostin is correlated with ACT in asthmatic patients. Methods: This research was an observational analytical with cross sectional design conducted in outpatient clinic Dr. Soetomo General Hospital Surabaya for 3 months. In total, we found 40 asthmatic patients who were qualified to the inclusion and exclusion criteria as the research samples. The questionnaire was filled in to assess the Asthma Control Test and venous blood tests to measure serum periostin levels using Sandwich Enzyme-Linked Immunosorbent Assay (ELISA) method. Results: The mean periostin level profile of the sample was 94.82 ± 19.21 ng/ml and the median was 94.7 ng/ml. The average ACT score was 16.55 ± 2.93 with 85% were uncontrolled asthma. The results of the independent t-test showed serum periostin levels and the level of asthma control based on ACT score in asthmatics patients had a significant correlation (p = 0.024). Conclusion: There is a significant correlation between serum periostin levels and ACT score in asthmatic patients.

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Asthma Control Test and Two Asthma-Symptom Questions Might Promise Successful Step-Down of Asthma Therapy in a Busy Clinical Practice

Journal of Allergy and Clinical Immunology ◽

10.1016/j.jaci.2007.12.240 ◽

2008 ◽

Vol 121 (2) ◽

pp. S60-S60

Author(s):

H TANAKASR

Keyword(s):

Clinical Practice ◽

Asthma Control ◽

Asthma Symptom ◽

Asthma Therapy ◽

Control Test ◽

Asthma Control Test ◽

Step Down

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Evaluation of association between airway hyperresponsiveness, asthma control test, and asthma therapy assessment questionnaire in asthmatic children

Multidisciplinary Respiratory Medicine ◽

10.4081/mrm.2013.546 ◽

2013 ◽

Vol 8 ◽

Author(s):

Daniele Rapino ◽

Marina Attanasi ◽

Nicola P. Consilvio ◽

Alessandra Scaparrotta ◽

Anna Cingolani ◽

...

Keyword(s):

Logistic Regression ◽

Asthma Control ◽

Asthma Therapy ◽

Control Test ◽

Uncontrolled Asthma ◽

Asthma Control Test ◽

Therapy Assessment ◽

Asthmatic Children ◽

Exercise Induced ◽

Assessment Questionnaire

Background: Achieving asthma control is a major challenge in children, otherwise symptoms perception remain poor especially at this age. The aim of this study is to evaluate the relationship between Asthma Control Test (ACTTM), Asthma Therapy Assessment Questionnaire (ATAQTM) and exercise-induced bronchospasm (EIB). Methods: We studied 80 asthmatic children. Airways hyperresponsiveness (AHR) was assessed by exercise-induced bronchospasm (Balke Protocol). Asthma control was evaluated using two questionnaires in all subjects: ACT (composed by Childhood-ACT and ACT) and ATAQ. In addition the use of short acting beta 2 agonist agents (SABAs) was assessed for each patient. Non-parametric variables were compared by Chi Square Test. Binomial logistic regression was performed to estimate the two questionnaires Odds Ratio (OR) in finding AHR. Results: We have found that ATAQ has a sensitivity and a specificity of 0.72 and 0.45 respectively; instead, ACT has a sensitivity and a specificity of 0.5 and 0.39 respectively in evaluating AHR. Patients with uncontrolled asthma according to ATAQ revealed a significant higher percentage of AHR compared with ACT (72% vs 50%, p < 0.01). Confirming this finding, patients declaring uncontrolled asthma to ATAQ have a significantly higher percentage (34%) of frequent SABAs use than the group with uncontrolled asthma to ACT (21%) (p <0.01). Binomial logistic regression shows how a test revealing uncontrolled asthma is associated with the increasing odds of having AHR according to ATAQ (OR = 3.8, p = 0.05), not to ACT (OR = 0.2, p = 0.1). Conclusions: Our results show that ATAQ reflects AHR and asthma control better than ACT. Children with uncontrolled asthma according to ATAQ have higher odds of having AHR and use of rescue medications (SABAs) compared to patients declaring uncontrolled asthma according to ACT. However both questionnaires are not sufficient alone to fully evaluate asthma control in children and it is always necessary to perform functional tests and investigate patients lifestyle, drug use and other important data that a simple questionnaire is not able to point out

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Identifying uncontrolled asthma in children with the childhood asthma control test or exhaled nitric oxide measurement

Annals of Allergy Asthma & Immunology ◽

10.1016/j.anai.2012.05.011 ◽

2012 ◽

Vol 109 (1) ◽

pp. 36-40 ◽

Cited By ~ 14

Author(s):

Suleyman Tolga Yavuz ◽

Ersoy Civelek ◽

Umit Murat Sahiner ◽

Ayse Betul Buyuktiryaki ◽

Ayfer Tuncer ◽

...

Keyword(s):

Nitric Oxide ◽

Asthma Control ◽

Childhood Asthma ◽

Exhaled Nitric Oxide ◽

Control Test ◽

Uncontrolled Asthma ◽

Asthma Control Test ◽

Asthma In Children

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Use of asthma control test in clinical practice

World Allergy Organization Journal ◽

10.1097/01.wox.0000301805.20620.3f ◽

2007 ◽

Vol &NA; ◽

pp. S171

Author(s):

Gabriella Galffy ◽

Lilla Tamasi ◽

Marta Orosz ◽

Gyorgy Losonczy

Keyword(s):

Clinical Practice ◽

Asthma Control ◽

Control Test ◽

Asthma Control Test

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Hubungan Keteraturan Penggunaan Kortikosteroid Inhalasi dengan Tingkat Kontrol Asma Pasien Berdasarkan ACT di Poliklinik Paru RSUP Dr. M. Djamil Padang

Jurnal Kesehatan Andalas ◽

10.25077/jka.v5i1.447 ◽

2016 ◽

Vol 5 (1) ◽

Author(s):

Wulan Prisilla Prisilla ◽

Irvan Medison ◽

Selfi Renita Rusjdi

Keyword(s):

Asthma Control ◽

Inhaled Corticosteroids ◽

Asthma Management ◽

The Elderly ◽

Control Test ◽

Uncontrolled Asthma ◽

Asthma Control Test ◽

Cross Sectional ◽

Kolmogorov Smirnov ◽

Smirnov Test

AbstrakAsma merupakan penyakit yang didasari oleh reaksi inflamasi pada saluran napas yang dapat dicegah dengan kortikosteroid inhalasi. Asma sukar disembuhkan, sehingga tujuan penatalaksanaan asma adalah asma terkontrol. Penilaian tingkat kontrol asma dapat dilakukan dengan menggunakan kuesioner Asthma Control Test (ACT) yang bersifat subjektif tetapi validitasnya telah diuji. Tujuan penelitian ini adalah menentukan hubungan keteraturan penggunaan kortikosteroid inhalasi dengan tingkat kontrol asma pasien berdasarkan ACT di Poliklinik Paru RSUP Dr. M. Djamil Padang. Penelitian cross sectional analytic ini telah dilakukan dari September hingga Desember 2013. Populasi adalah pasien berusia ≥14 tahun yang didiagnosis asma oleh dokter. Jumlah subjek penelitian sebanyak 96 orang. Data yang diperoleh diolah dan dianalisis menggunakan uji Kolmogorov-Smirnov. Insiden terbanyak asma berada pada kelompok usia lanjut (60,4%). Sebagian besar pasien tidak teratur menggunakan kortikosteroid inhalasi (63,5%) dan pasien dengan asma tidak terkontrol memiliki proporsi tertinggi (59,4%) . Analisis statistik menunjukkan bahwa terdapat hubungan yang bermakna antara keteraturan penggunaan kortikosteroid inhalasi dengan tingkat kontrol asma pasien berdasarkan ACT di Poliklinik Paru RSUP Dr. M. Djamil (p=0,002).Kata kunci: kortikosteroid inhalasi, ACT, tingkat control asma AbstractAsthma is a disease caused by an inflammatory reaction in the patient airways that can be prevented with inhaled corticosteroids. It is known that there is no cure for asthma, so the goal of asthma management is to obtain controlled asthma. The level of asthma control can be assessed by using Asthma Control Test (ACT) questionnaire, this method is subjective but its validity has been tested. The objective of this study was to determine the association between regularity of inhaled corticosteroids application and patient’s level of asthma control based on ACT in the Lung Clinic of Dr. M. Djamil Padang Hospital. A cross sectional analitic was conducted from September to December 2013. The population is patient aged ≥14 years old who were diagnosed with asthma by a doctor. The number of samples is 96 people. The data were processed and analyzed using the Kolmogorov-Smirnov test. The incidence of asthma was highest in the elderly (60,4%). Most patients do not regularly use inhaled corticosteroids (63.5%) and patients with uncontrolled asthma had the highest proportion (59.4%) in this research. Based on statistic analisys, there was significant association between regularity of inhaled corticosteroids application and patient’s level of asthma control based on ACT in the lung clinic of Dr. M. Djamil Padang Hospital (p=0,002).Keywords: inhaled corticosteroids, ACT, level of asthma control

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