Difference in Asthma Control Test™ (ACT) scores in three different clinical practice settings.
BACKGROUND
Asthma control varies in different clinical settings because of its multidimensional and heterogeneous nature, and variability over time. The revised asthma management guidelines indicate that the goal of treatment should be maintaining asthma control for long periods. The aims of this study were to explore: (i) difference in asthma control test scores in patients at different clinical practice settings; (ii) assess if patients were overestimating the level of their asthma control and (iii) assess the relationship of the derived Asthma Control Test (ACT) score to cost of inpatient stay and length of stay (LOS).


METHODS
The Asthma Control Test (ACT) is a 5-item questionnaire that assesses the multidimensional perspective of asthma control from activity limitation, shortness of breath, night symptoms, use of rescue medication and self-perception of asthma control. The score ranges on a scale from 1 (poorly controlled) to 5 (well controlled). ACT was administered to 447 patients diagnosed with asthma from the in-patient and out-patient settings (new and follow-up cases).


RESULTS
Three hundred and ninety-nine (92%) patients completed the ACT questionnaire. The analysis only included patients who had completed the ACT questionnaire. The analysis showed that all the 5 items in the ACT questionnaire were significantly associated with different clinical settings (P <0.001). When we correlated the ACT question 5 (patients' self-rating of asthma control) in the ACT with Question 3 and Question 4 individually, it showed that most patients did not overestimate their asthma control (P <0.001). However, there was no correlation between the derived ACT score and cost (P = 0.419), LOS (P = 0.373), and the number of comorbid medical history (P = 0.055).


CONCLUSIONS
Our results reinforce the usefulness of ACT for clinicians to identify patients with poorly controlled asthma and to optimise their level of control in different clinical settings.
Department of Nursing, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore. lathy_prabhakaran@ttsh.com.sg
Lathy
L
Prabhakaran
Earnest
E
Arul
John
J
Abisheganaden
Jane
J
Chee
D000328:Adult; D001249:Asthma / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D006760:Hospitalization; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000145:classification*; D011320:Primary Health Care; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D055815:Young Adult