Comparison between two methods of asthma control evaluation based on individual perception.
OBJECTIVE
To compare the subjective perception of asthma control reported by the patient with that measured by the score obtained on the Asthma Control Questionnaire 6-item version (ACQ-6) in patients with severe asthma and to determine whether asthma control is associated with the number of emergency room visits in the previous month.


METHODS
This was a cross-sectional study involving 528 patients treated at the Bahia State Asthma and Allergic Rhinitis Control Program Central Referral Clinic between August of 2008 and March of 2010, in the city of Salvador, Brazil. The patients completed the ACQ-6 and answered a specific additional question in order to evaluate their own perception of asthma control in the previous week.


RESULTS
We evaluated 423 patients who met the inclusion criteria. The sample was predominantly female (81.3%), and 64.3% had an income lower than two times the national minimum wage. The mean age was 49.85 ± 13.71 years, and the duration of asthma symptoms was 32.11 ± 16.35 years. The patients had been regularly treated via the program for 36.65 ± 18.10 months. Based on the subjective perception of asthma control, only 8% of the patients considered their asthma to be uncontrolled, whereas 38.8% had an ACQ-6 score > 1.5, which indicates poor control. The kappa statistic revealed poor concordance between the two methods. There was a direct association between uncontrolled asthma and the number of emergency room visits in the previous month (p < 0.001).


CONCLUSIONS
In this sample of patients, the subjective perception of asthma control differed from that measured by the ACQ-6 score, and the patients overestimated their own level of asthma control, which puts them at risk of being undertreated.
Programa para o Controle da Asma e Rinite Alérgica, Salvador, BA, Brazil. paulafisio.respir@gmail.com
Paula Cristina Andrade
PC
Almeida
Adelmir
A
Souza-Machado
Mylene dos Santos
Mdos S
Leite
Lourdes Alzimar Mendes de
LA
Castro
Ana Carla Carvalho
AC
Coelho
Constança Sampaio
CS
Cruz
Alvaro Augusto
AA
Cruz
D017668:Age of Onset; D001249:Asthma / Q000145:classification / Q000188:drug therapy* / Q000523:psychology*; D001938:Brazil; D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010465:Perception / Q000502:physiology*; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires