Assessing asthma control in routine clinical practice: use of the Royal College of Physicians '3 questions'.
OBJECTIVE
To evaluate the Royal College of Physicians (RCP) '3 questions' in the assessment of asthma control.


METHODS
This was a prospective observational study. Subjects (20 adults and 15 children) were assessed 2-weekly over 12 weeks, with data collection on RCP scores (yes/no for each question, 0-3), lung function, asthma control questionnaire (ACQ), asthma quality of life questionnaires (AQLQ), bronchodilator use, and exhaled nitric oxide level.


RESULTS
Between-subject analysis showed that the RCP score correlated strongly with the ACQ (correlation coefficient 0.79, p<0.001), AQLQ (-0.71, p=0.001) and bronchodilator use (0.52, p=0.02) in adults, although in children the correlations were weaker and nonsignificant. Within-subject analysis showed strong correlations between changes in the RCP score and ACQ score in adults (0.67, p<0.001) and children (0.61, p<0.001), between quality of life scores in adults (-0.67, p<0.001) and children (-0.69, p<0.001), and changes in bronchodilator use in adults (0.49, p<0.001) and children (0.48, p<0.001). Weaker or absent correlations existed with lung function and no correlations with exhaled nitric oxide levels. An RCP score of 1 or more identified 89% of occasions when the ACQ was >1.


CONCLUSIONS
The RCP 3 questions reliably quantify current asthma control in this dataset, with a negative response to all 3 questions indicating good control. These data support the use of the 3 questions, but larger validation studies are needed.
Thomas
Mike
M
Department of General Practice and Primary Care, University of Aberdeen, Scotland, UK. mikethomas@doctors.org.uk
Gruffydd-Jones
Kevin
K
Stonham
Carol
C
Ward
Sabbi
S
Macfarlane
Tatiana V
TV
D000293:Adolescent; D000328:Adult; D000368:Aged; D000554:Ambulatory Care Facilities; D001249:Asthma / Q000175:diagnosis* / Q000188:drug therapy; D001993:Bronchodilator Agents / Q000627:therapeutic use; D002648:Child; D006801:Humans; D055118:Medication Adherence; D008875:Middle Aged; D009722:Nurse Practitioners; D011446:Prospective Studies; D011788:Quality of Life; D012720:Severity of Illness Index; D013147:Spirometry; D055815:Young Adult
D001993:Bronchodilator Agents