title: Comparing the Asthma APGAR system and the Asthma Control Test™ in a multicenter primary care sample.
abstract: OBJECTIVE
  To compare asthma control assessment using the Asthma APGAR system, a tool developed by primary care clinicians, in a multicenter primary care sample with the Asthma Control Test (ACT™)/Childhood Asthma Control Test (CACT™), a tool developed by asthma specialists.
  
  
  METHODS
  This is a substudy of a multicenter, randomized, controlled pragmatic trial that tests the effectiveness of the Asthma APGAR system in primary care practices. As part of the study, enrolled patients completed both the ACT™/CACT™ and the Asthma APGAR system between March 1, 2011, and December 31, 2011. Kappa and McNemar statistics were used to compare the results of questionnaires.
  
  
  RESULTS
  Of the 468 patients in our sample, 306 (65%) were classified as not controlled by the ACT™/CACT™ or the Asthma APGAR system. The overall agreement was 84.4%, with a kappa value of .68 (substantial agreement) and a McNemar test P value of .35 (suggesting no significant difference in the direction of disagreement). Of those with poor control as defined by the Asthma APGAR system, 23.8% (73) had no controller medications and 76.5% (234) were seldom or sometimes able to avoid identified triggers for their asthma. Of those who stated that they had been prescribed controller medications, 116 of 332 (35%) stated that they did not use the controller medication on a daily basis.
  
  
  CONCLUSIONS
  The Asthma APGAR system and the ACT™/CACT™ similarly assess asthma control in a multicenter primary care-based sample. The Asthma APGAR system identified an "actionable item" in more than 75% (234) of the individuals with poor asthma control, thus linking an assessment of poor asthma control with a management strategy.
authors.affiliation: Division of Allergy, Asthma, and Clinical Immunology, Mayo Clinic, Scottsdale, AZ.
authors.forename: Matthew A
authors.initials: MA
authors.lastname: Rank
authors.affiliation: Olmsted Medical Center Research, Rochester, MN.
authors.forename: Susan
authors.initials: S
authors.lastname: Bertram
authors.affiliation: Olmsted Medical Center Research, Rochester, MN.
authors.forename: Peter
authors.initials: P
authors.lastname: Wollan
authors.affiliation: Olmsted Medical Center Research, Rochester, MN.
authors.forename: Roy A
authors.initials: RA
authors.lastname: Yawn
authors.affiliation: Olmsted Medical Center Research, Rochester, MN. Electronic address: Byawn@olmmed.org.
authors.forename: Barbara P
authors.initials: BP
authors.lastname: Yawn
mesh_terms: D000293:Adolescent; D000328:Adult; D000465:Algorithms; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use; D001249:Asthma / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003661:Decision Support Techniques; D016903:Drug Monitoring / Q000379:methods; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D011320:Primary Health Care; D012307:Risk Factors; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D018927:Anti-Asthmatic Agents