Evaluation of the Asthma Control Test; a reliable determinant of disease stability and a predictor of future exacerbations.
Summary of "Evaluation of the Asthma Control Test; a reliable determinant of disease stability and a predictor of future exacerbations."
SUMMARY AT A
Single, but not serial, measurement of ACT is useful for assessing asthma control, prediction of exacerbation and changes in treatment decisions.
Background and Objective: This study assessed the asthma control test (ACT) cut-off values for asthma control according to the GINA guideline in adults and the effectiveness of ACT scores in predicting exacerbations and serial changes in ACT scores over time in relation to treatment decisions. Methods: Subjects completed ACT together with same-day spirometry and fractional concentration of exhaled nitric oxide (FeNO) measurement at baseline and at 3 months. Physicians, blinded to the ACT scores and FeNO values, assessed the patient's asthma control in the past month and adjusted the asthma medications according to management guidelines. Asthma exacerbations and urgent healthcare utilization (HCU) at 6 months were recorded. Results: 379 (120men) asthmatics completed the study. The ACT cut-off for uncontrolled and partly controlled asthma were ≤19 (sensitivity 0.74, specificity 0.67, % correctly classified 69.5) and ≤22 respectively (sensitivity 0.73, specificity 0.71, % correctly classified 72.1). Baseline ACT score had an odds ratio of 2.34 (95%CI 1.48-3.69) and 2.66 (1.70-4.18) for urgent HCU and exacerbations respectively at 6 months (p < 0.0001). However, baseline FeNO and spirometry values had no association with urgent HCU and exacerbations. The 3-month ACT score of ≤20 correlated best with step-up of asthma medications (sensitivity 0.65, specificity 0.81, % correctly classified 72.8). For serial changes of ACT scores over 3 months, the cutoff value was best at ≤3 for treatment decisions with low sensitivity (0.23) and % correctly classified (57.3%) values. Conclusions: Single measurement of ACT is useful for assessing asthma control, prediction of exacerbation and changes in treatment decisions.
Department of Medicine and Therapeutics, Department of Pediatrics, The Chinese University of Hong Kong.
This article was published in the following journal.
Name: Respirology (Carlton, Vic.)
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/22107482
- DOI: http://dx.doi.org/10.1111/j.1440-1843.2011.02105.x
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