Asthma Control Test: Reliability, validity, and responsiveness in patients not previously followed by asthma specialists

Schatz, Michael; Sorkness, Christine A.; Li, James T.; Marcus, Philip; Murray, John; Nathan, Robert A.; Kosinski, Mark; Pendergraft, Trudy; Jhingran, Priti

doi:10.1016/j.jaci.2006.01.011

Cited by 1,013 publications

(898 citation statements)

References 15 publications

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“…Lung function, blood eosinophils and neutrophils, IgE levels, fraction of exhaled nitric oxide (FeNO), interleukin-6 (IL-6), and high sensitivity C-reactive protein (hsCRP) were measured. Patients also filled Asthma Control Test (ACT) [22], AQ20, and a structured lifestyle questionnaire. Specifically trained research nurse reviewed all questionnaires with the patients to limit misunderstandings.…”

Section: Methodsmentioning

confidence: 99%

Daily physical activity and lung function decline in adult-onset asthma: a 12-year follow-up study

Loponen

Ilmarinen

Tuomisto

et al. 2018

European Clinical Respiratory Journal

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Background: There is a lack of knowledge on the association between daily physical activity and lung function in patients with asthma. Objective: This study aims to examine the association between daily physical activity and asthma control, lung function, and lung function decline in patients with adult-onset asthma. Design: This study is part of Seinäjoki Adult Asthma Study (SAAS), where 201 patients were followed for 12 years after asthma diagnosis. Daily physical activity was assessed at follow-up by a structured questionnaire and used to classify the population into subgroups of low (≤240 min) or high (>240 min) physical activity. Three spirometry evaluation points were used: 1. diagnosis, 2. the maximum lung function during the first 2.5 years after diagnosis (Max0-2.5), 3. follow-up at 12 years. Results: High physical activity group had slower annual FEV1 (p<0.001) and FVC (p<0.018) decline. Additionally, the high physical activity group had higher FEV1 values at follow-up, and higher FEV1/FVC ratios at follow-up and diagnosis. There was no difference in BMI, smoking, medication, or frequency of physical exercise between high and low physical activity groups. Differences remained significant after adjustments for possible confounding factors. Conclusion: This is the first demonstration of an association between long-term FEV1 decline and daily physical activity in clinical asthma. Low physical activity is independently associated with faster decline in lung function. Daily physical activity should be recommended in treatment guidelines in asthma.

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Section: Methodsmentioning

confidence: 99%

Daily physical activity and lung function decline in adult-onset asthma: a 12-year follow-up study

Loponen

Ilmarinen

Tuomisto

et al. 2018

European Clinical Respiratory Journal

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“…Control of disease is defined as a disease state in which the symptoms are not considered bothersome anymore to the patient 1. The 2012 EPOS expert committee proposed an assessment of clinical control of CRS (Table 1), following the concept of the validated asthma control test 2. The proposed CRS control test takes into account the presence and severity of the four major sinonasal symptoms, sleep disturbance and/or fatigue, nasal endoscopic evaluation and need for oral medication.…”

mentioning

confidence: 99%

Real-life study showing uncontrolled rhinosinusitis after sinus surgery in a tertiary referral centre

Veen

Seys

Timmermans

et al. 2016

Allergy

126

128

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RationaleThe European Position Paper on Sinusitis (EPOS) guidelines provide composite criteria to evaluate chronic rhinosinusitis (CRS) control, taking into consideration the severity of patients’ symptoms, aspect of nasal mucosa and medical intake as parameters of CRS control.ObjectivesTo study the degree of CRS control using novel EPOS control criteria at 3–5 years after a functional endoscopic sinus surgery (FESS) and correlate these data to symptoms scores.MethodsAdult CRS patients (n = 560) who had undergone bilateral FESS for chronic inflammatory sinonasal disease 3–5 years prior to the study were included. Patients received a postal questionnaire asking for control items according to EPOS control criteria, visual analogue scale (VAS) scores for total and individual sinonasal symptoms, sinonasal outcome test (SNOT)‐22 and Short Form (SF)‐36 questionnaires.Measurements and main resultsAbout 19.5% of CRS patients were well controlled, with 36.8% of patients being partly controlled and 43.7% uncontrolled. The levels of control corresponded to mean total VAS, SNOT‐22 and SF‐36 scores. Subgroup analysis revealed that female gender, aspirin intolerance and revision FESS were associated with higher prevalence of uncontrolled CRS, whereas allergy, asthma and smoking status did not alter the percentage of patients in each category of control. In 81 patients attending the outpatient clinic, nasal endoscopy changed classification in only four patients (4.9%).ConclusionsBased on the novel EPOS control criteria, at least 40% of CRS patients are uncontrolled at 3–5 years after FESS. Therefore, better treatment strategies leading to higher disease control are warranted in CRS care.

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“…Alpaydin et al 11 reported a statistically significant association between ACT and the Asthma Quality of Life Questionnaire (AQLQ). 12 Another study 13 reported a strong correlation between the ACT and the ACQ. 14 In contrast, moderate to low correlations were observed between the ACT score and FEV 1 , F ENO , and specialists' rating of control according to NAEPP EPR-3 guidelines.…”

Section: Validitymentioning

confidence: 99%

“…9,15,16 The substantially low correlations between the ACT scores and physiologic measures of asthma, such as FEV 1 values and F ENO , support the notion that asthma control cannot be inferred from physiologic measures alone. 14,17 Furthermore, the ACT has been validated in many languages [18][19][20][21][22][23] and in different settings, including in asthma specialist consultations, 9 in primary care, 13 in pharmacies, 24 by mail, 25 by speech-recognition telephone calls, 26 and over the internet. 27 …”

Section: Validitymentioning

confidence: 99%

“…9,13,25,30 A cutoff score of Յ19 was associated with higher risk of adverse asthma outcomes, such as asthma exacerbation 17,31 and urgent health-care utilization. 17,32 With regard to NAEPP EPR-3 guidelines, a score of Ն20 indicates well-controlled asthma, a score of 16 -19 indicates not well-controlled asthma, and a score of Յ15 indicates very poorly controlled asthma.…”

Section: Accuracymentioning

confidence: 99%

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Asthma Control Assessment Tools

Alzahrani

Becker

2015

Respir Care

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, and they emphasize periodic assessment of asthma control once treatment is established. Accurate assessment of asthma control is difficult due to the complexity of asthma control and due to the limitations in the traditional methods of assessment, such as lung function tests, physician assessment, and patients' self-assessment. Relying solely on the role of lung function tests is insufficient to reflect the status of asthma control, since patients with asthma may have normal spirometry between exacerbations. Clinicians often overestimate the level of asthma control. Similarly, it is not uncommon for patients to overestimate how well their asthma is controlled, and, therefore, they under-report asthma symptoms and fail to recognize the impact that asthma has on their daily life. As a result, several tools have been developed to quantify the level of asthma control, identify patients at risk, and evaluate the effect of asthma management. This review examines the commonly 106RESPIRATORY CARE • JANUARY 2016 VOL 61 NO 1 used asthma control assessment tools in terms of content, psychometric properties, methods of administration, limitations, and ability to reflect the overall status of asthma control, which can aid clinicians in selecting the most appropriate tool for their needs.

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Asthma Control Test: Reliability, validity, and responsiveness in patients not previously followed by asthma specialists

Cited by 1,013 publications

References 15 publications

Daily physical activity and lung function decline in adult-onset asthma: a 12-year follow-up study

Daily physical activity and lung function decline in adult-onset asthma: a 12-year follow-up study

Real-life study showing uncontrolled rhinosinusitis after sinus surgery in a tertiary referral centre

Asthma Control Assessment Tools

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