Predicting asthma control using patient attitudes toward medical care: the REACT score.
BACKGROUND
The association between patients' degree of asthma control and their attitudes toward medical professionals and asthma therapy is unknown.


OBJECTIVE
To develop a tool, the REACT Score, that can be used by physicians to compute the risk of having uncontrolled asthma based on patient attitudes toward medical professionals and asthma treatment.


METHODS
A nationally representative sample of adult patients (> or = 18 years old) with moderate to severe asthma completed the Asthma Control Test and were surveyed regarding their attitudes about relationships with medical professionals and asthma treatments. Competing predictive models were developed to determine the association between attitude questions and asthma control. Using the model with the highest c-index, a REACT Score was computed.


RESULTS
The proportion of uncontrolled patients (Asthma Control Test score < 20) in the high-, medium-, and low-risk REACT Score categories was 75%, 50%, and 24%, respectively. Patients who believed that their physician recognized lifestyle compromises due to asthma, who were not satisfied with their treatment regimen, and who took asthma medication more frequently than prescribed had a higher risk of poor asthma control.


CONCLUSIONS
The REACT Score is a novel way to predict asthma control and to identify key attitudes and behaviors that need to be addressed to engage a patient in ongoing, effective care. This tool may also improve communication between asthmatic patients and their physicians by identifying patient concerns regarding their treatment and quality of life.
Jones
Craig A
CA
Agency of Administration, Montpelier, Vermont 05609, USA. Craig.Jones@state.vt.us
Bender
Bruce G
BG
Haselkorn
Tmirah
T
Fish
James E
JE
Mink
David R
DR
Peters
Stephen P
SP
Weiss
Scott T
ST
D000328:Adult; D001249:Asthma / Q000188:drug therapy*; D001294:Attitude to Health; D005260:Female; D006306:Health Surveys; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D016017:Odds Ratio; D010342:Patient Acceptance of Health Care; D010349:Patient Compliance / Q000523:psychology; D017060:Patient Satisfaction; D010361:Patients / Q000523:psychology*; D010817:Physician-Patient Relations; D012307:Risk Factors; D011795:Surveys and Questionnaires; D016896:Treatment Outcome