title: The use of the Asthma Control Test in general practice and its correlation with asthma control according to the GINA guidelines.
abstract: BACKGROUND
  The GINA guidelines have redefined the primary goal of asthma treatment as achieving optimum control.
  
  
  OBJECTIVE
  To document the level of asthma control in Switzerland, the correlations between the international guidelines by GINA and the ACT's rating of asthma control, current treatment in adolescent and adult Swiss asthma patients and factors associated with asthma control.
  
  
  METHODS
  General practitioners and specialists (pulmonologists, allergologists and paediatricians) were invited to participate in the cross-sectional survey. Asthma control was assessed in 1093 asthma patients using both the ACT and the GINA classification for asthma control.
  
  
  RESULTS
  According to the GINA guidelines controlled asthma was found in 290 (27%) patients, when measured with the ACT 124 (11.5%) patients showed sufficient asthma control. Of the test results 65% were in accordance with each other, whereas in 85% of the non-matching results the ACT underestimated control according to GINA classification. An ACT cut-off score of ≤17 best identified uncontrolled asthma according to GINA guidelines. A total of 956 (87.7%) patients received controller medication and 849 (77.9%) patients received reliever medication. The following parameters were consistently identified to be significantly associated with insufficient asthma control in both GINA and ACT measurements: presence of exacerbation, use of reliever medication, switch of therapy and smoking.
  
  
  CONCLUSIONS
  For this study only the ACT version for adults was used.
  
  
  CONCLUSIONS
  Asthma control remains insufficient in the majority of patients, despite prescription of regular controller medication. This survey confirms the validated ACT to be useful and important in everyday practice as an objective measure for asthma control according to GINA guidelines in order to monitor control and adjust treatment.
authors: University Hospital Basel, Internal Medicine, Basel, Switzerland. david.miedinger@unibas.ch
authors: David
authors: D
authors: Miedinger
authors: E
authors: E
authors: Neukomm
authors: P N
authors: PN
authors: Chhajed
authors: A
authors: A
authors: Schnyder
authors: M
authors: M
authors: Naef
authors: M
authors: M
authors: Ackermann
authors: J D
authors: JD
authors: Leuppi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001249:Asthma / Q000628:therapy*; D002648:Child; D003430:Cross-Sectional Studies; D003625:Data Collection; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods; D017410:Practice Guidelines as Topic; D013557:Switzerland